title: Two-year outcomes following unprotected left main stenting with first vs. new-generation drug-eluting stents: the FINE registry.
abstract: OBJECTIVE
  To assess two-year outcomes following first vs. new-generation drug-eluting stent (DES) implantation in unprotected left main (ULMCA) percutaneous coronary intervention.
  
  
  RESULTS
  All eligible patients from our two-centre registry treated with first and new-generation DES from October 2006 to November 2010 were analysed. The study objective was major adverse cardiac events (MACE), defined as all-cause mortality, target vessel revascularisation (TVR) and myocardial infarction (MI) at two years. In total, 186 patients were included: 93 (50.0%) treated with first vs. 93 (50.0%) with new-generation DES. No differences were observed in baseline clinical characteristics except for higher EuroSCORE with new-generation DES (3.6±2.5 vs. 4.6±2.7; p=0.007). No significant difference was observed in stenting techniques; two stents were used respectively in 53.8% vs. 44.1% (p=0.187). Notably, intravascular ultrasound guidance was more frequent with new-generation DES (46.2% vs. 61.3%; p=0.040). At 730.0 (interquartile range 365.5-1,224.5) days, there was a trend towards improved MACE with new-generation DES (31.2% vs. 19.6%; p=0.070) and a significant reduction in TVR (23.7% vs. 12.0%; p=0.038) and MI (4.3% vs. 0%; p=0.044). Notably, there were four cases of definite stent thrombosis (ST) with first vs. none with new-generation DES (p=0.044).
  
  
  CONCLUSIONS
  In our study, new-generation DES had a trend for less MACE and improved results with regard to MI, TVR and definite ST at two-year follow-up.
authors.affiliation: San Raffaele Scientific Institute, Milan, Italy.
authors.forename: Gill Louise
authors.initials: GL
authors.lastname: Buchanan
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.forename: Chiara
authors.initials: C
authors.lastname: Bernelli
authors.forename: Matteo
authors.initials: M
authors.lastname: Montorfano
authors.forename: Mauro
authors.initials: M
authors.lastname: Carlino
authors.forename: Azeem
authors.initials: A
authors.lastname: Latib
authors.forename: Filippo
authors.initials: F
authors.lastname: Figini
authors.forename: Francesco
authors.initials: F
authors.lastname: Giannini
authors.forename: Alessandro
authors.initials: A
authors.lastname: Durante
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ielasi
authors.forename: Alfredo
authors.initials: A
authors.lastname: Castelli
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
mesh_terms: D054855:Drug-Eluting Stents; D006801:Humans; D062645:Percutaneous Coronary Intervention; D012042:Registries; D015607:Stents; D016896:Treatment Outcome