PCI is an increasingly utilized method of revascularization in patients with ULMCA.
This multicenter prospective registry included 252 patients after ULMCA stenting enrolled between March 1997 and February 2008. Non–ST-segment elevation acute coronary syndrome was diagnosed in 58 % of patients; ST-segment elevation myocardial infarction cases were excluded. Drug-eluting stents were implanted in 36.2 % of patients.
Major adverse cardiovascular and cerebral events (MACCE) occurred in 12 (4.8 % ) patients during the 30-day period, which included 4 (1.5 % ) deaths. After 12 months there were 17 (12.1 % ) angiographically confirmed cases of restenosis. During long-term follow-up (1 to 11 years, mean 3.8 years) there were 64 (25.4 % ) MACCE and 35 (13.9 % ) deaths. The 5- and 10-year survival rates were 78.1 % and 68.9 % , respectively. Despite differences in demographical and clinical data in favor of BMS patients, unmatched analysis showed a significantly lower MACCE rate in DES patients (25.9 % vs. 14.9 % , p = 0.039). This difference was strengthened after propensity score matching. The DES lowered both mortality and MACCE for distal ULMCA lesions when compared with BMS. Ejection fraction <50 % was the only independent risk factor influencing long-term survival.
Stenting of ULMCA is feasible and offers good long-term outcome. Implantation of DES for ULMCA decreased the risk of long-term MACCE, and particularly improved survival in patients with distal ULMCA disease.