AIMS: This study sought to report the 10-year clinical outcomes of patients who underwent unprotected left main (LM) percutaneous coronary intervention (PCI) in a large centre. METHODS AND RESULTS: A total of 913 consecutive patients who underwent unprotected LM PCI from January 2004 to December 2008 at Fu Wai Hospital were retrospectively analysed; the mean age was 60.0 ± 10.9 years, females accounted for 22% of patients, diabetes was present in 27.7% of patients, and an LM bifurcation lesion occurred in 82.9% of patients. During the median follow-up of 9.7 years, major adverse cardiac or cerebrovascular events (MACCEs) occurred in 25.6% (234) of patients, and the rates of all-cause death, myocardial infarction, and stroke were 14.9%, 11.0%, and 7.1%, respectively. Cardiac death occurred in only 7.9% of patients. The estimated event rate was 41.9% for death/myocardial infarction/any revascularization and 45.9% for death/MI/stroke/any revascularization. Definite/probable stent thrombosis occurred in 4.3% (39) of patients. According to the subgroup analysis, IVUS-guided PCI was associated with less long-term MACCEs. Further multivariate analysis identified that age and LVEF<40% were the only independent predictors for 10-year death. Age, LVEF<40%, creatinine clearance, and incomplete revascularization were independent predictors for death/MI, while a two-stent strategy, diabetes, a transradial approach, and the use of bare metal stents (BMSs) or first-generation drug-eluting stents (DESs) were not. CONCLUSIONS: Unprotected LM PCI in a large cohort of consecutive patients in a single large centre demonstrated favourable long-term outcomes up to 10 years even with the use of BMSs and first-generation of DESs.
AIMS: This study sought to report the 10-year clinical outcomes of patients who underwent unprotected left main (LM) percutaneous coronary intervention (PCI) in a large centre. METHODS AND RESULTS: A total of 913 consecutive patients who underwent unprotected LM PCI from January 2004 to December 2008 at Fu Wai Hospital were retrospectively analysed; the mean age was 60.0 ± 10.9 years, females accounted for 22% of patients, diabetes was present in 27.7% of patients, and an LM bifurcation lesion occurred in 82.9% of patients. During the median follow-up of 9.7 years, major adverse cardiac or cerebrovascular events (MACCEs) occurred in 25.6% (234) of patients, and the rates of all-cause death, myocardial infarction, and stroke were 14.9%, 11.0%, and 7.1%, respectively. Cardiac death occurred in only 7.9% of patients. The estimated event rate was 41.9% for death/myocardial infarction/any revascularization and 45.9% for death/MI/stroke/any revascularization. Definite/probable stent thrombosis occurred in 4.3% (39) of patients. According to the subgroup analysis, IVUS-guided PCI was associated with less long-term MACCEs. Further multivariate analysis identified that age and LVEF<40% were the only independent predictors for 10-year death. Age, LVEF<40%, creatinine clearance, and incomplete revascularization were independent predictors for death/MI, while a two-stent strategy, diabetes, a transradial approach, and the use of bare metal stents (BMSs) or first-generation drug-eluting stents (DESs) were not. CONCLUSIONS: Unprotected LM PCI in a large cohort of consecutive patients in a single large centre demonstrated favourable long-term outcomes up to 10 years even with the use of BMSs and first-generation of DESs.
Authors: Jose M de la Torre Hernandez; Felipe Hernández Hernandez; Fernando Alfonso; Jose R Rumoroso; Ramon Lopez-Palop; Mario Sadaba; Pilar Carrillo; Juan Rondan; Iñigo Lozano; Juan M Ruiz Nodar; Jose A Baz; Eduard Fernandez Nofrerias; Fernando Pajin; Tamara Garcia Camarero; Hipolito Gutierrez Journal: J Am Coll Cardiol Date: 2011-07-19 Impact factor: 24.094
Authors: Andy S C Yong; David Daniels; Bernard De Bruyne; Hyun-Sook Kim; Fumiaki Ikeno; Jennifer Lyons; Nico H J Pijls; William F Fearon Journal: Circ Cardiovasc Interv Date: 2013-04-02 Impact factor: 6.546
Authors: Daniel J F M Thuijs; A Pieter Kappetein; Patrick W Serruys; Friedrich-Wilhelm Mohr; Marie-Claude Morice; Michael J Mack; David R Holmes; Nick Curzen; Piroze Davierwala; Thilo Noack; Milan Milojevic; Keith D Dawkins; Bruno R da Costa; Peter Jüni; Stuart J Head Journal: Lancet Date: 2019-09-02 Impact factor: 79.321
Authors: Young Soo Oh; Hyun Jong Lee; Juneyoung Lee; Young Jin Choi; Rak Kyeung Choi; Cheol Woong Yu; Jinsik Park; Jin-Oh Choi; Je Sang Kim; Tae-Hoon Kim; Ho-Jun Jang; Seung Woo Park; Sang Hoon Lee Journal: Coron Artery Dis Date: 2019-06 Impact factor: 1.439