Two-Year Clinical Outcome With Drug-Eluting Stents Versus Bare-Metal Stents in a Real-World Registry of Unprotected Left Main Coronary Artery Stenosis from the Italian Society of Invasive Cardiology

Data are limited about the relative efficacy of drug-eluting stents (DESs) versus bare-metal stents (BMSs) for the treatment of unprotected left main coronary artery (ULMCA) stenosis. The survey promoted by the Italian Society of Invasive Cardiology on ULMCA stenosis was an observational study invol...

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Bibliographic Details
Published in:The American journal of cardiology 2008-12, Vol.102 (11), p.1463-1468
Main Authors: Palmerini, Tullio, MD, Marzocchi, Antonio, MD, Tamburino, Corrado, MD, Sheiban, Imad, MD, Margheri, Massimo, MD, Vecchi, Giuseppe, MD, Sangiorgi, Giuseppe, MD, Santarelli, Andrea, MD, Bartorelli, Antonio, MD, Briguori, Carlo, MD, PhD, Vignali, Luigi, MD, Di Pede, Francesco, MD, Ramondo, Angelo, MD, Inglese, Luigi, MD, De Carlo, Marco, MD, Bolognese, Leonardo, MD, Benassi, Alberto, MD, Palmieri, Cataldo, MD, Filippone, Vincenzo, MD, Sangiorgi, Diego, MSc, De Servi, Stefano, MD
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cardiology
Cardiology. Vascular system
Cardiovascular
Clinical outcomes
Comparative studies
Coronary Stenosis - mortality
Coronary Stenosis - surgery
Coronary Stenosis - therapy
Coronary vessels
Drug-Eluting Stents
Female
Health Surveys
Humans
Italy
Male
Medical procedures
Medical sciences
Medical treatment
Middle Aged
Qualitative research
Registries
Retrospective Studies
Risk Factors
Severity of Illness Index
Stents
Time Factors
Treatment Outcome
Young Adult
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Summary:Data are limited about the relative efficacy of drug-eluting stents (DESs) versus bare-metal stents (BMSs) for the treatment of unprotected left main coronary artery (ULMCA) stenosis. The survey promoted by the Italian Society of Invasive Cardiology on ULMCA stenosis was an observational study involving 19 high-volume Italian centers of patients with ULMCA stenosis treated using percutaneous coronary intervention (PCI). From January 2002 to December 2006, of 1,453 patients identified with ULMCA stenosis treated with PCI, 1,111 were treated with DESs and 342 were treated with BMSs. During a 2-year follow-up, risk-adjusted survival free from cardiac death was significantly higher in patients treated with DESs than in those treated with BMSs. The propensity-adjusted hazard ratio for risk of 2-year cardiac mortality after DES versus BMS implantation was 0.49 (95% confidence interval 0.32 to 0.77). The benefit of DESs in reducing cardiac mortality was obtained in the period from 3 to 6 months and maintained up to 2 years. In conclusion, for patients with ULMCA stenosis undergoing PCI, DES implantation was associated with higher adjusted rates of 2-year survival free from cardiac death. The benefit of DESs in reducing cardiac mortality was obtained in the period in which clinical manifestations of restenosis usually peak.
ISSN:0002-9149
1879-1913
DOI:10.1016/j.amjcard.2008.07.030