Provisional vs. two-stent technique for unprotected left main coronary artery disease after ten years follow up: A propensity matched analysis

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• 作者：Fabrizio D'Ascenzo^a ; ^{fabrizio.dascenzo@gmail.com" class="auth_mail" title="E-mail the corresponding author} ; Mario Iannaccone^a ; Francesca Giordana^a ; Alaide Chieffo^c ; Stephen O. Connor^d ; L. Christian Napp^j ; SujaySubash Chandran^b ; José ; Marí ; a de la Torre Herná ; ndez^h ; Shao-Liang Chen^a ; Ferdinando Varbellaⁱ ; Pierluigi Omedè ; ^a ; Salma Taha^a ; Emanuele Meliga^e ; Hiroyoshi Kawamoto^c ; Antonio Montefusco^a ; Mervyn Chong^b ; Philippe Garot^d ; Lin Sin^a ; Valeria Gasparetto^f ; Mohamed Abdirashid^a ; Enrico Cerrato^g ; ⁱ ; Giuseppe Biondi-Zoccai^k ; ^l ; Fiorenzo Gaita^a ; Javier Escaned^g ; David Hiddick Smith^b ; Thierry Lefè ; vre^d ; Antonio Colombo^c ; Imad Sheiban^a ; ^f ; Claudio Moretti^a ; ^b
• 关键词：Unprotected left main ; Bifurcation ; Stenting ; Drug eluting stent
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 May 2016
• 年：2016
• 卷：211
• 期：Complete
• 页码：37-42
• 全文大小：1062 K

文摘

There is uncertainty on which stenting approach confers the best long-term outlook for unprotected left main (ULM) bifurcation disease.

Methods and 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.

Conclusion

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.