Clinical outcomes of complete, partially complete, and incomplete revascularisation at five-year follow-up after percutaneous intervention of unprotected left main coronary artery disease with drug-eluting stents

Yao Jun Zhang, Javaid Iqbal, Bo Xu, Fei Ye, Jun Jie Zhang, Christos V. Bourantas, Dao Rong Pan, Nai Liang Tian, Jing Kan, Xue Song Qian, Shi Qing Ding, Feng Li, Ai Ping Zhang, Yue Qiang Liu, Takashi Muramatsu, Yoshinobu Onuma, Hector M. Garcia-Garcia, Patrick W. Serruys, Shao Liang Chen

研究成果: Article査読

2 被引用数 (Scopus)

抄録

Aims: The study aimed to examine five-year clinical outcomes of complete (CR), partially complete (PCR), and incomplete revascularisation (ICR) in patients with unprotected left main coronary artery (ULMCA) disease treated with drug-eluting stents (DES). Completeness of revascularisation, defined as revascularisation of all vessels ≥1.5 or 2.5 mm in diameter, has been shown to correlate with outcomes after percutaneous coronary intervention (PCI). There are no data to compare revascularisation strategies on long-term clinical outcomes in patients undergoing PCI of ULMCA disease. Methods and results: This prospective registry enrolled 910 consecutive patients with ULMCA disease undergoing PCI with DES implantation. CR included patients who had a successful revascularisation of all diseased segments with diameter ≥1.5 mm. PCR included patients who had successful revascularisation of all diseased segments with diameter ≥2.5 mm. ICR included patients who did not achieve revascularisation for all diseased segments of diameter ≥2.5 mm. The primary endpoint was the incidence of major adverse cardiac events (MACE: a composite of cardiac death, myocardial infarction and repeat revascularisation) at five-year follow-up. CR was achieved in 386 (42.4%), PCR in 227 (25.0%), and ICR in 297 (32.6%) patients. Patients with ICR had a significantly higher rate of MACE (29.6% vs. 22.5% and 15.5%, p<0.001) and all-cause mortality (12.5% vs. 7.0% and 6.2%; p≥0.006) than those with CR and PCR at five-year follow-up. After propensity score matching, patients with CR vs. PCR had similar incidences of MACE (hazard ratio [HR]: 1.16, 95% confidence interval [CI]: 0.78-1.74, p≥0.46), mortality (HR: 1.27, 95% CI: 0.61-2.63, p≥0.53), and cardiac death (1.8% vs. 4.5%; HR: 2.56, 95% CI: 0.80-8.17, p≥0.11). On multivariable logistic regression analysis, ICR appears to be an outcome of poor clinical characteristics, comorbidities and complex coronary anatomy. Conclusions: In the treatment of patients with ULMCA disease, ICR was associated with worse long-term clinical outcomes than CR and PCR. PCR has clinical outcomes similar to CR in patients with ULMCA disease treated with DES.

本文言語English
ページ(範囲)e957-e963
ジャーナルEuroIntervention
12
8
DOI
出版ステータスPublished - 10-2016
外部発表はい

All Science Journal Classification (ASJC) codes

  • 循環器および心血管医学

フィンガープリント

「Clinical outcomes of complete, partially complete, and incomplete revascularisation at five-year follow-up after percutaneous intervention of unprotected left main coronary artery disease with drug-eluting stents」の研究トピックを掘り下げます。これらがまとまってユニークなフィンガープリントを構成します。

引用スタイル