Long-term follow-up (four years) of unprotected left main coronary artery disease treated with paclitaxel-eluting stents (from the TRUE Registry)

Cosmo Godino, Guido Parodi, Shinichi Furuichi, Azeem Latib, Rossella Barbagallo, Omer Goktekin, Michela Cera, Ralf Mueller, Corrado Tamburino, Eberhard Grube, Carlo Di Mario, Bernard Reimers, Alaide Chieffo, David Antoniucci, Antonio Colombo, Giuseppe M. Sangiorgi

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Aims: Limited data are available on the long-term outcome following PCI with paclitaxel-eluting stent (PES) implantation in patients with unprotected left main coronary artery (LMCA). The objective of this study was to evaluate "real world" long-term outcome following paclitaxel-eluting stent (PES) implantation for unprotected LMCA disease in patients enrolled in the TRUE registry. Methods and results: From March 2003 to October 2004, 93 consecutive patients (81.7% male) underwent PCI for unprotected LMCA disease. Surveillance angiography was performed at 6.8±3.3 months follow-up. The target lesion involved the distal LMCA in 68 (73.1%) patients. Double stenting techniques were performed in 46 (67.6%) distal LMCA, of these 50% were stented using the Crush technique. Clinical follow-up was complete in all patients with 85.8% angiographic follow-up rate. In-segment restenosis occurred in 16 (20.3%) patients and was focal in 72.4% of cases and significantly higher in patients with distal LMCA (36.8% vs. 13.6%, p<0.04). At a median follow-up of 1,450 days (IQR 1281-1595), the overall incidence of MACE was 35.5% and the TLR rate was 25.8% and significantly higher in patients with bifurcation stenting (32.3% vs. 8%, p<0.02). The estimated cardiac survival rate at one and four years was 96.7% and 93.3%, respectively. Total mortality rate was 14.1% and cardiac was 6.5%. There was one (1.1%) definite stent thrombosis (ST) and one (1.1%) probable ST. Conclusions: Treatment of unprotected LMCA disease with PES, after four years follow-up, appears to be safe and effective with a low rate of cardiac mortality and overall risk of ST. The need for target lesion revascularisation in 25.8% of patients highlights the need for more effective PCI especially in patients with distal LMCA disease.

Original languageEnglish (US)
Pages (from-to)906-916
Number of pages11
JournalEuroIntervention
Volume5
Issue number8
DOIs
StatePublished - Apr 2010
Externally publishedYes

Keywords

  • Coronary arteries
  • Coronary stenosis
  • Revascularisation
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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