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Comparison of 5-year outcomes in patients with and without unprotected left main coronary artery disease after treatment with sirolimus-eluting stents: insights from the j-Cypher registry.
| Content Provider | Semantic Scholar |
|---|---|
| Author | Toyofuku, Mamoru Kimura, Takeshi Morimoto, Takeshi Hayashi, Yasuhiko Shiode, Nobuo Nishikawa, Hideo Nakao, Koichi Shirota, Kinya Kawai, Kazuya Hiasa, Yoshikazu Kadota, Kazushige Nozaki, Yoichi Isshiki, Takaaki Sone, Takahito Mitsudo, Kazuaki |
| Copyright Year | 2013 |
| Abstract | OBJECTIVES This study assessed 5-year outcomes after implantation of sirolimus-eluting stents (SES) for unprotected left main coronary artery (ULMCA) disease in comparison with that for non-left main disease. BACKGROUND More information on long-term outcomes after ULMCA stenting is needed. METHODS The j-Cypher is a multicenter prospective registry of consecutive patients undergoing SES implantation in Japan. RESULTS Among 12,812 patients enrolled in the j-Cypher registry, the unadjusted mortality rate at 5 years was significantly higher in patients with ULMCA stenting than in patients without ULMCA stenting (22.8% vs. 14.1%; p < 0.0001); however, the risk for death with ULMCA stenting was no longer significant after adjusting for confounders (hazard ratio: 1.18, 95% confidence interval: 0.95 to 1.46; p = 0.14). In the lesion-level comparison, the nonbifurcation ULMCA lesions treated exclusively with SES had a significantly lower rate of target lesion revascularization (TLR) than those in non-ULMCA nonbifurcation lesions (2.4% vs. 12.7%; p = 0.04). Among bifurcation lesions, those treated with a provisional 2-stent approach had similar rates of TLR (12.1% vs. 11.4%; p = 0.79) between the ULMCA and non-ULMCA groups. Lesions treated with an elective 2-stent approach had higher TLR rates in the ULMCA group as compared with the non-ULMCA group (33.5% vs. 19.7%; p = 0.002). CONCLUSIONS The safety of ULMCA stenting relative to non-LMCA stenting was maintained through 5 years follow-up. In terms of efficacy, SES implantation in nonbifurcation ULMCA lesions was associated with an extremely low cumulative incidence of TLR, whereas the elective 2-stent approach for ULMCA bifurcation lesions was associated with a markedly higher cumulative incidence of TLR as compared with that for non-ULMCA bifurcation lesions. |
| File Format | PDF HTM / HTML |
| DOI | 10.1016/j.jcin.2013.03.015 |
| PubMed reference number | 23866178 |
| Journal | Medline |
| Volume Number | 6 |
| Issue Number | 7 |
| Alternate Webpage(s) | https://core.ac.uk/download/pdf/82601007.pdf |
| Alternate Webpage(s) | http://www.interventions.onlinejacc.org/content/jint/6/7/654.full.pdf |
| Alternate Webpage(s) | https://doi.org/10.1016/j.jcin.2013.03.015 |
| Journal | JACC. Cardiovascular interventions |
| Language | English |
| Access Restriction | Open |
| Content Type | Text |
| Resource Type | Article |
