title: Proximal coronary artery intervention: stent thrombosis, restenosis and death.
abstract: BACKGROUND
  Percutaneous coronary intervention (PCI) of lesions in the proximal left anterior descending coronary artery (LAD) may confer a worse prognosis compared with the proximal right coronary artery (RCA) and left circumflex coronary artery (LCX).
  
  
  METHODS
  From May 2005, to May 2011 we identified all PCIs for proximal, one-vessel coronary artery disease in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). We evaluated restenosis, stent thrombosis (ST) and mortality in the LAD as compared to the RCA and LCX according to stent type, bare metal (BMS) or drug-eluting stents (DES).
  
  
  RESULTS
  7840 single vessel proximal PCI procedures were identified. Mean follow-up time was 792 days. No differences in restenosis or ST were seen between the LAD and the RCA. The frequency of restenosis and ST was higher in the proximal LAD compared to the proximal LCX (restenosis: hazard ratio (HR) 2.28, confidence interval (CI) 1.56-3.34 p<0.001; ST: HR 2.32, CI 1.11-4.85 p=0.024). We found no difference in mortality related to coronary artery. In the proximal LAD, DES implantation was associated with a lower restenosis rate (HR 0.39, CI 0.27-0.55 p<0.001) and mortality (HR 0.58, CI 0.41-0.82 p=0.002) compared with BMS. In the proximal RCA and LCX, DES use was not associated with lower frequency of clinical restenosis or mortality.
  
  
  CONCLUSIONS
  Following proximal coronary artery intervention restenosis was more frequent in the LAD than in the LCX. Solely in the proximal LAD we found DES use to be associated with a lower risk of restenosis and death weighted against BMS.
authors.affiliation: Department of Cardiology, Örebro University Hospital, Örebro, Sweden.
authors.forename: Fredrik
authors.initials: F
authors.lastname: Calais
authors.forename: Bo
authors.initials: B
authors.lastname: Lagerqvist
authors.forename: Jerzy
authors.initials: J
authors.lastname: Leppert
authors.forename: Stefan K
authors.initials: SK
authors.lastname: James
authors.forename: Ole
authors.initials: O
authors.lastname: Fröbert
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease / Q000401:mortality* / Q000628:therapy; D023903:Coronary Restenosis / Q000209:etiology / Q000401:mortality*; D003328:Coronary Thrombosis / Q000209:etiology / Q000401:mortality*; D003331:Coronary Vessels; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods / Q000401:mortality*; D016016:Proportional Hazards Models; D012042:Registries / Q000706:statistics & numerical data; D015607:Stents / Q000009:adverse effects*; D013548:Sweden / Q000453:epidemiology
chemical_list: D008670:Metals
keywords: Angioplasty; Coronary artery disease; Drug-eluting stents