title: Provisional vs. two-stent technique for unprotected left main coronary artery disease after ten years follow up: A propensity matched analysis.
abstract: OBJECTIVE
  There is uncertainty on which stenting approach confers the best long-term outlook for unprotected left main (ULM) bifurcation disease.
  
  
  RESULTS
  This is a non-randomized, retrospective study including all consecutive patients with 50% stenosis of the left main involving at least 1 of the arteries stemming from the left main treated with drug-eluting stents (DES) in 9 European centers between 2002 and 2004. Patients were divided into two groups: those treated with provisional stentings vs. those treated with two stent strategy. The outcomes of interest were 10-year rates of target lesion revascularization (TLR), major adverse cardiac events (MACE), and their components (cardiovascular death, myocardial infarction [MI], or repeat revascularization), along with stent thrombosis (ST). A total of 285 patients were included, 178 (62.5%) in the provisional stenting group and 87 (37.5%) in the two stent group. After 10 years, no differences in TLR were found at unadjusted analysis (19% vs 25%, p>0.05) nor after propensity score matching (25% vs 28%, p>0.05). Similar rates of MACE (60% vs 66%, p>0.05), death (34% vs 43%, p>0.05), MI (9% vs 14%, p>0.05) and ST were also disclosed at propensity-based analysis.
  
  
  CONCLUSIONS
  Even after 10 year follow-up, patients treated with provisional stenting on left main showed comparable rates of target lesion revascularization compared to two stent strategy.
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy. Electronic address: fabrizio.dascenzo@gmail.com.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Iannaccone
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Giordana
authors.affiliation: Scientific Institute S. Raffaele, Milan, Italy.
authors.forename: Alaide
authors.initials: A
authors.lastname: Chieffo
authors.affiliation: Department of Cardiology, Institut Cardiovasculaire Paris Stud, Hôpital Privé Jacques Cartier, Générale de Santé, Massy, France.
authors.forename: Stephen O
authors.initials: SO
authors.lastname: Connor
authors.affiliation: Department of Cardiology and Angiology, Hannover Medical School, Hannover, Germany.
authors.forename: L Christian
authors.initials: LC
authors.lastname: Napp
authors.affiliation: Division of Cardiology, Brighton, United Kingdom.
authors.forename: SujaySubash
authors.initials: S
authors.lastname: Chandran
authors.affiliation: Servicio de Cardiología, Hospital Marqués de Valdecilla, Santander, Cantabria, Spain.
authors.forename: José María
authors.initials: JM
authors.lastname: de la Torre Hernández
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Shao-Liang
authors.initials: SL
authors.lastname: Chen
authors.affiliation: Cardiology Department, Ospedale degli Infermi, Rivoli, TO, Italy.
authors.forename: Ferdinando
authors.initials: F
authors.lastname: Varbella
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Omedè
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Salma
authors.initials: S
authors.lastname: Taha
authors.affiliation: Divisione di Cardiologia, Ospedale Mauriziano, Italy.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Meliga
authors.affiliation: Scientific Institute S. Raffaele, Milan, Italy.
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Kawamoto
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Montefusco
authors.affiliation: Division of Cardiology, Brighton, United Kingdom.
authors.forename: Mervyn
authors.initials: M
authors.lastname: Chong
authors.affiliation: Department of Cardiology, Institut Cardiovasculaire Paris Stud, Hôpital Privé Jacques Cartier, Générale de Santé, Massy, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Lin
authors.initials: L
authors.lastname: Sin
authors.affiliation: Division di Cardiologia, Ospedale Pederzoli, Italy.
authors.forename: Valeria
authors.initials: V
authors.lastname: Gasparetto
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdirashid
authors.affiliation: Cardiovascular Institute, Hospital Clínico San Carlos, 28040 Madrid, Spain; Cardiology Department, Ospedale degli Infermi, Rivoli, TO, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Cerrato
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Eleonora Lorillard Spencer Cenci Foundation, Rome, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Cardiovascular Institute, Hospital Clínico San Carlos, 28040 Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Escaned
authors.affiliation: Division of Cardiology, Brighton, United Kingdom.
authors.forename: David
authors.initials: D
authors.lastname: Hiddick Smith
authors.affiliation: Department of Cardiology, Institut Cardiovasculaire Paris Stud, Hôpital Privé Jacques Cartier, Générale de Santé, Massy, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.affiliation: Scientific Institute S. Raffaele, Milan, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Colombo
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy; Division di Cardiologia, Ospedale Pederzoli, Italy.
authors.forename: Imad
authors.initials: I
authors.lastname: Sheiban
authors.affiliation: Dipartimento di Scienze Mediche, Divisione di Cardiologia, Città della Salute e della Scienza, Turin, Italy; Division of Cardiology, Brighton, United Kingdom.
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D054855:Drug-Eluting Stents / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bifurcation; Drug eluting stent; Stenting; Unprotected left main