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Comparison of the Efficacy of Drug-eluting Stents Versus Bare-metal Stents for the Treatment of Left Main Coronary Artery Disease

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文摘 Background: Recent studies reported that percutaneous coronary intervention with stent implantation was safe and feasible for the treatment of left main coronary artery (LMCA) disease in select patients. However, it is unclear whether drug-eluting stents (DESs) have better outcomes in patients with LMCA disease compared with bare-metal stent (BMS) during long-term follow-up in Chinese populations. Methods: From a perspective multicenter registry, 1136 consecutive patients, who underwent BMS or DES implantation for unprotected LMCA stenosis, were divided into two groups: 1007 underwent DES implantation, and 129 underwent BMS implantation. The primary outcome was the rate of major adverse cardiac events (MACEs), including cardiovascular (CV) death, myocardial infarction (MI), and target lesion revascularization (TLR) at 5 years postimplantation. Results: Patients in the DES group were older and more likely to have hyperlipidemia and bifurcation lesions. They had smaller vessels and longer lesions than patients in the BMS group. In the adjusted cohort of patients, the DES group had significantly lower 5 years rates of MACE (19.4% vs. 31.8%, P = 0.022), CV death (7.0% vs. 14.7%, P= 0.045), and MI (5.4% vs. 12.4%, P= 0.049) than the BMS group. There were no significant differences in the rate of TLR (10.9% vs. 17.8%, P= 0.110) and stent thrombosis (4.7% vs. 3.9%, P = 0.758). The rates of MACE (80.6% vs. 68.2%, P = 0.023), CV death (93.0% vs. 85.3%, P = 0.045), TLR (84.5% vs. 72.1%, P = 0.014), and MI (89.9% vs. 80.6%, P = 0.029) free survival were significantly higher in the DES group than in the BMS group. When the propensity score was included as a covariate in the Cox model, the adjusted hazard ratios for the risk of CV death and MI were 0.41 (95% confidence interval [CI]: 0.21-0.63, P = 0.029) and 0.29 (95% CI: 0.08-0.92, P= 0.037), respectively. Conclusions: DES implantation was associated with more favorable clinical outcomes than BMS implantation for the treatment of LMCA disease even though there was no significant difference in the rate of TLR between the two groups.
来源 Chinese Medical Journal ,2015,128(6):721-726 【核心库】
DOI 10.4103/0366-6999.152460
关键词 Bare-metal Stent ; Drug-eluting Stent ; Left Main Coronary Artery Disease ; Percutaneous Coronary Intervention
地址

1. Department of Cardiology, General Hospital of Shenyang Military Region, Liaoning, Shenyang, 110840  

2. Department of Cardiology, Nanjing First Hospital Affiliated to Nanjing Medical University, Jiangsu, Nanjing, 210006

语种 英文
文献类型 研究性论文
ISSN 0366-6999
学科 内科学
文献收藏号 CSCD:5363378

参考文献 共 30 共2页

1.  Windecker S. 2014 ESC/EACTS Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-thoracic Surgery (EACTS) Developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J,2014,35:2541-2619 CSCD被引 154 次    
2.  Kushner F G. 2009 focused updates: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction (updating the 2004 guideline and 2007 focused update) and ACC/AHA/SCAI guidelines on percutaneous coronary intervention (updating the 2005 guideline and 2007 focused update): A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol,2009,54:2205-2241 CSCD被引 76 次    
3.  Patel M R. ACCF/SCAI/STS/AATS/AHA/ASNC 2009 appropriateness criteria for coronary revascularization: A report of the American College of Cardiology Foundation Appropriateness Criteria Task Force, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and the American Society of Nuclear Cardiology: Endorsed by the American Society of Echocardiography, the Heart Failure Society of America, and the Society of Cardiovascular Computed Tomography. J Am Coll Cardiol,2009,53:530-553 CSCD被引 16 次    
4.  Silvestri M. Unprotected left main coronary artery stenting: Immediate and medium-term outcomes of 140 elective procedures. J Am Coll Cardiol,2000,35:1543-1550 CSCD被引 10 次    
5.  Black A. Unprotected left main coronary artery stenting: Correlates of midterm survival and impact of patient selection. J Am Coll Cardiol,2001,37:832-838 CSCD被引 8 次    
6.  Park S J. Elective stenting of unprotected left main coronary artery stenosis: Effect of debulking before stenting and intravascular ultrasound guidance. J Am Coll Cardiol,2001,38:1054-1060 CSCD被引 8 次    
7.  Chieffo A. Early and mid-term results of drug-eluting stent implantation in unprotected left main. Circulation,2005,111:791-795 CSCD被引 14 次    
8.  Valgimigli M. Short-and long-term clinical outcome after drug-eluting stent implantation for the percutaneous treatment of left main coronary artery disease: Insights from the Rapamycin-eluting and Taxus Stent Evaluated at Rotterdam Cardiology Hospital registries (RESEARCH and T-SEARCH). Circulation,2005,111:1383-1389 CSCD被引 16 次    
9.  Park S J. Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis: Comparison with bare metal stent implantation. J Am Coll Cardiol,2005,45:351-356 CSCD被引 15 次    
10.  Kim Y H. Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents. Circulation,2009,120:400-407 CSCD被引 2 次    
11.  Iakovou I. Incidence, predictors, and outcome of thrombosis after successful implantation of drug-eluting stents. JAMA,2005,293:2126-2130 CSCD被引 124 次    
12.  Stone G W. Safety and efficacy of sirolimus-and paclitaxel-eluting coronary stents. N Engl J Med,2007,356:998-1008 CSCD被引 67 次    
13.  Mauri L. Stent thrombosis in randomized clinical trials of drug-eluting stents. N Engl J Med,2007,356:1020-1029 CSCD被引 61 次    
14.  Kuchulakanti P K. Correlates and long-term outcomes of angiographically proven stent thrombosis with sirolimus-and paclitaxel-eluting stents. Circulation,2006,113:1108-1113 CSCD被引 26 次    
15.  Farb A. Stent thrombosis redux-The FDA perspective. N Engl J Med,2007,356:984-987 CSCD被引 3 次    
16.  Pandya S B. Drug-eluting versus bare-metal stents in unprotected left main coronary artery stenosis a meta-analysis. JACC Cardiovasc Interv,2010,3:602-611 CSCD被引 1 次    
17.  Price M J. Serial angiographic follow-up of sirolimus-eluting stents for unprotected left main coronary artery revascularization. J Am Coll Cardiol,2006,47:871-877 CSCD被引 10 次    
18.  Palmerini T. Comparison between coronary angioplasty and coronary artery bypass surgery for the treatment of unprotected left main coronary artery stenosis (the Bologna Registry). Am J Cardiol,2006,98:54-59 CSCD被引 3 次    
19.  Lee M S. Comparison of coronary artery bypass surgery with percutaneous coronary intervention with drug-eluting stents for unprotected left main coronary artery disease. J Am Coll Cardiol,2006,47:864-870 CSCD被引 15 次    
20.  Kim Y H. Effectiveness of drug-eluting stent implantation for patients with unprotected left main coronary artery stenosis. Am J Cardiol,2008,101:801-806 CSCD被引 1 次    
引证文献 3 篇

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