Early and Long-Term Outcomes After Percutaneous Coronary Intervention of Unprotected Left Main Coronary Disease With Drug-Eluting Stents in Patients With Non-ST¨CElevation Acute Coronary Syndrome

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• 作者：Chuanyan Zhao ; MD^a ; Xin Wang ; MD^b ; Xiaoyan Wu ; MD^a ; Lianqun Cui ; MD^a ; ^{cuilianqun@hotmail.com}
• 刊名：Canadian Journal of Cardiology
• 出版年：2011
• 出版时间：November-December 2011
• 年：2011
• 卷：27
• 期：6
• 页码：743-748
• 全文大小：577 K

文摘

Background

Patients presenting with non-ST¨Celevation acute coronary syndrome (NSTE-ACS) and unprotected left main coronary disease (ULMCD) are among the highest risk patients but current consensus guidelines do not address the optimal timing and mode of revascularization for these individuals.

Methods

In this single-centre registry, we evaluated the clinical outcomes of 151 consecutive patients with NSTE-ACS and ULMCD who underwent percutaneous coronary intervention with drug-eluting stents from 2005 to 2009.

Results

Overall in-hospital major adverse cardiac event (MACE) rate was 5.3 % , mortality rate was 0.7 % . At 30 months ¡À 15 months, 30 patients (19.9 % ) experienced MACE. The 4-year cumulative survival rate of no MACE was 73.2 % and cumulative survival rate was 90.6 % . Left ventricular ejection fraction (hazard ratio [HR] 0.947; 95 % confidence interval [CI], 0.898-0.998; P = 0.043) and SYNTAX [SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery] score ?33 (HR 1.28; 95 % CI, 1.025-1.433; P = 0.029) were associated with MACE, while only left ventricular ejection fraction (HR 0.82; 95 % CI, 0.69-0.973; P = 0.023) was associated with mortality.

Conclusions

Our study demonstrates the feasibility of percutaneous coronary intervention with drug-eluting stents in patients with NSTE-ACS and ULMCD. The early and long-term outcomes were acceptable. Left ventricular ejection fraction and SYNTAX score ?33 predict MACE and only left ventricular ejection fraction predicts mortality.