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Efficacy of stenting for unprotected left main coronary artery disease in 297 patients

Ya-ling Han1, Shou-li Wang, Quan-min Jin

  • 1Department of Cardiology, Shenyang General Hospital of PLA, Shenyang 110016, China. hanyal@mail.sy.ln.cn

Chinese Medical Journal
|April 20, 2006
PubMed

Insights

Percutaneous coronary intervention (PCI) using stenting, including drug-eluting stents (DES), is safe and effective for treating unprotected left main coronary artery (LMCA) disease. The DES era showed significantly lower in-hospital and long-term adverse events compared to the pre-DES era.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Medicine

Background:

  • Percutaneous coronary intervention (PCI) for unprotected left main coronary artery (LMCA) disease remains a topic of debate.
  • Evaluating the safety and effectiveness of stenting, including bare metal stents and drug-eluting stents (DES), is crucial for LMCA treatment.

Purpose of the Study:

  • To assess the safety and clinical outcomes of stenting for unprotected LMCA disease.
  • To compare outcomes between the pre-DES and DES eras for LMCA stenting.

Main Methods:

  • A retrospective analysis of 297 consecutive patients undergoing PCI for LMCA lesions between September 1997 and December 2005.
  • Comparison of in-hospital and clinical follow-up data between the pre-DES era (Sept 1997-Dec 2002) and the DES era (Jan 2003-Dec 2004).

Main Results:

  • 368 coronary stents were successfully deployed in 295 patients; 2 patients required coronary artery bypass grafting (CABG).
  • In-hospital major adverse cardiac events (MACE) were 2.0%, with 14.5% MACE at follow-up (including cardiac death, myocardial infarction, subacute thrombosis, and target lesion revascularization).
  • The DES era (Group II) demonstrated significantly lower in-hospital MACE (1.1% vs. 9.4%), and lower long-term MACE, TLR, and restenosis rates compared to the pre-DES era (Group I) (all P < 0.05).

Conclusions:

  • Coronary stenting, particularly with DES, is technically successful and safe for treating unprotected LMCA lesions.
  • New PCI strategies and devices like DES have led to improved in-hospital and long-term outcomes compared to CABG for LMCA disease.
Abstract

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