TY - JOUR
T1 - Long-term clinical outcomes following elective stent implantation for unprotected left main coronary artery disease
AU - Hu, Wei Syun
AU - Lee, Shih Huang
AU - Chiu, Chiung Zuan
AU - Shyu, Kou Gi
AU - Lin, Shen Chang
AU - Hung, Huei Fong
AU - Liou, Jer Young
AU - Cheng, Jun Jack
PY - 2011/1
Y1 - 2011/1
N2 - Background/Purpose: Percutaneous coronary intervention (PCI) has been increasingly adopted for unprotected left main coronary artery (LMCA) disease. The aim of this study was to evaluate the predictors of long-term clinical outcomes in patients after elective stent implantation for unprotected LMCA disease. Methods: A total of 122 patients with medically refractory angina who received coronary stenting for unprotected LMCA disease between August 1997 and December 2008 were included. Results: During the follow-up period of 45 ±35 months (range: 1-137 months), the incidence of repeated PCI and/or coronary artery bypass grafting (CABG), and cardiovascular and total mortality were 28% (34 patients), 20% (24 patients), and 25% (31 patients), respectively. Multivariate analysis revealed that young age [p = 0.02; hazard ratio (HR): 2.19, 95% confidence interval (CI): 1.11-4.30] and bare-metal stent (BMS) use (p=0.02; HR: 5.35, 95% CI: 1.27-22.57) were the independent predictors of repeated PCI and/or CABG. Only lower left ventricular ejection fraction (LVEF) could predict both cardiovascular mortality (p=0.003; HR: 4.25, 95% CI: 1.63-11.08) and total mortality (p=0.002; HR: 3.95, 95% CI: 1.65-9.45). Lower LVEF (p=0.001; HR: 0.31, 95% CI: 0.16-0.61) and small stent size (p=0.01; HR: 5.95, 95% CI: 1.43-24.80) could predict the composite endpoint, including target vessel revascularization and total mortality. Conclusion: We showed that young age and BMS implantation could predict repeated PCI and/or CABG after stent implantation for unprotected LMCA disease. Only lower LVEF could predict both cardiovascular and total mortality. Lower LVEF and small stent size but not BMS implantation could predict composite target vessel revascularization/total mortality.
AB - Background/Purpose: Percutaneous coronary intervention (PCI) has been increasingly adopted for unprotected left main coronary artery (LMCA) disease. The aim of this study was to evaluate the predictors of long-term clinical outcomes in patients after elective stent implantation for unprotected LMCA disease. Methods: A total of 122 patients with medically refractory angina who received coronary stenting for unprotected LMCA disease between August 1997 and December 2008 were included. Results: During the follow-up period of 45 ±35 months (range: 1-137 months), the incidence of repeated PCI and/or coronary artery bypass grafting (CABG), and cardiovascular and total mortality were 28% (34 patients), 20% (24 patients), and 25% (31 patients), respectively. Multivariate analysis revealed that young age [p = 0.02; hazard ratio (HR): 2.19, 95% confidence interval (CI): 1.11-4.30] and bare-metal stent (BMS) use (p=0.02; HR: 5.35, 95% CI: 1.27-22.57) were the independent predictors of repeated PCI and/or CABG. Only lower left ventricular ejection fraction (LVEF) could predict both cardiovascular mortality (p=0.003; HR: 4.25, 95% CI: 1.63-11.08) and total mortality (p=0.002; HR: 3.95, 95% CI: 1.65-9.45). Lower LVEF (p=0.001; HR: 0.31, 95% CI: 0.16-0.61) and small stent size (p=0.01; HR: 5.95, 95% CI: 1.43-24.80) could predict the composite endpoint, including target vessel revascularization and total mortality. Conclusion: We showed that young age and BMS implantation could predict repeated PCI and/or CABG after stent implantation for unprotected LMCA disease. Only lower LVEF could predict both cardiovascular and total mortality. Lower LVEF and small stent size but not BMS implantation could predict composite target vessel revascularization/total mortality.
KW - Coronary artery disease
KW - Left main coronary artery
KW - Percutaneous coronary intervention
KW - Stent
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U2 - 10.1016/S0929-6646(11)60004-1
DO - 10.1016/S0929-6646(11)60004-1
M3 - Article
AN - SCOPUS:79955488487
SN - 0929-6646
VL - 110
SP - 19
EP - 26
JO - Journal of the Formosan Medical Association
JF - Journal of the Formosan Medical Association
IS - 1
ER -