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Three-year outcomes after sirolimus-eluting stent implantation for unprotected left main coronary artery disease: insights from the j-Cypher registry.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Toyofuku, Mamoru Kimura, Takeshi Morimoto, Tatsuya Hayashi, Yasuhito Ueda, Hiroaki Kawai, Kazuya Nozaki, Yuichi Hiramatsu, Shinichi Miura, Akira B. Yokoi, Yoshiaki Toyoshima, Shinichiro Nakashima, Hitoshi Kurashiki-City Haze, Kazuo Take, Shunsuke Saito, Shigeru Isshiki, Takaaki Mitsudo, Kazushige |
| Copyright Year | 2009 |
| Abstract | BACKGROUND Long-term outcomes after stenting of an unprotected left main coronary artery (ULMCA) with drug-eluting stents have not been addressed adequately despite the growing popularity of this procedure. METHODS AND RESULTS j-Cypher is a multicenter prospective registry of consecutive patients undergoing sirolimus-eluting stent implantation in Japan. Among 12 824 patients enrolled in the j-Cypher registry, the unadjusted mortality rate at 3 years was significantly higher in patients with ULMCA stenting (n=582) than in patients without ULMCA stenting (n=12 242; 14.6% versus 9.2%, respectively; P<0.0001); however, there was no significant difference between the 2 groups in the adjusted risk of death (hazard ratio 1.23, 95% confidence interval 0.95 to 1.60, P=0.12). Among 476 patients whose ULMCA lesions were treated exclusively with a sirolimus-eluting stent, patients with ostial/shaft lesions (n=96) compared with those with bifurcation lesions (n=380) had a significantly lower rate of target-lesion revascularization for the ULMCA lesions (3.6% versus 17.1%, P=0.005), with similar cardiac death rates at 3 years (9.8% versus 7.6%, P=0.41). Among patients with bifurcation lesions, patients with stenting of both the main and side branches (n=119) had significantly higher rates of cardiac death (12.2% versus 5.5%; P=0.02) and target-lesion revascularization (30.9% versus 11.1%; P<0.0001) than those with main-branch stenting alone (n=261). CONCLUSIONS The higher unadjusted mortality rate of patients undergoing ULMCA stenting with a sirolimus-eluting stent did not appear to be related to ULMCA treatment itself but rather to the patients' high-risk profile. Although long-term outcomes in patients with ostial/shaft ULMCA lesions were favorable, outcomes in patients with bifurcation lesions treated with stenting of both the main and side branches appeared unacceptable. |
| Starting Page | E8909 |
| Ending Page | E8918 |
| Page Count | 1 |
| File Format | PDF HTM / HTML |
| Alternate Webpage(s) | http://circ.ahajournals.org/content/circulationaha/120/19/1866.full.pdf?download=true |
| PubMed reference number | 19858414v1 |
| Alternate Webpage(s) | https://doi.org/10.1161/CIRCULATIONAHA.109.873349 |
| DOI | 10.1161/circulationaha.109.873349 |
| Journal | Circulation |
| Volume Number | 120 |
| Issue Number | 19 |
| Language | English |
| Access Restriction | Open |
| Subject Keyword | Arteriopathic disease Artificial cardiac pacemaker Cardiac Death Cessation of life Confidence Intervals Coronary Artery Disease Drug-Eluting Stents Left coronary artery structure Patients Registries Shaft Device Component Sirolimus Stent Device Component Stent, device revascularization |
| Content Type | Text |
| Resource Type | Article |
