Very long-term outcomes after percutaneous coronary intervention with bare metal stents for unprotected left main coronary artery disease

Akihiro Nomura, Kyohei Yamaji, Shinichi Shirai, Fumio Omata, Yoshimitsu Soga, Michio Nagashima, Takeshi Arita, Kenji Ando, Koyu Sakai, Masahiko Goya, Hiroyoshi Yokoi, Masashi Iwabuchi, Masakiyo Nobuyoshi

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Aims: The aim of this study was to evaluate very long-term clinical outcomes and potential predictors after percutaneous coronary intervention (PCI) with bare metal stents (BMS) for unprotected left main coronary artery disease (ULMCAD). Methods and results: From March 1991 to August 2001, 151 patients who underwent PCI with BMS for ULMCAD were investigated retrospectively. The patient-oriented major adverse cardiac events (MACE) were defined as the occurrence of all-cause death, any MI, and any coronary revascularisation. The median follow-up duration was 10.5 years. The mean age was 69.9±11.5 years, and 106 patients (70.2%) were male. At 10 years, the incidences of cardiac death (CD), target lesion revascularisation (TLR) and patient-oriented MACE were 11.1%, 25.2% and 81.9%, respectively. In multivariate analysis, the pre-reference diameter of the left main trunk (LMT) was significantly associated with TLR (adjusted hazard ratio [HR] [95% confidence interval (CI)], 0.28 [0.14-0.54], p<0.001) and the SYNTAX score remained an independent predictor of patient-oriented MACE (adjusted HR [95% CI], 1.03 [1.007-1.05], p=0.009). Conclusions: The pre-reference diameter of LMT was significantly associated with TLR, and the SYNTAX score significantly predicted the risk of patient-oriented MACE at 10 years. BMS implantation for larger size of ULMCAD with a lower SYNTAX score was feasible for up to 10 years.

Original languageEnglish
Pages (from-to)962-969
Number of pages8
JournalEuroIntervention
Volume8
Issue number8
DOIs
Publication statusPublished - Dec 1 2012
Externally publishedYes

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Percutaneous Coronary Intervention
Stents
Coronary Artery Disease
Metals
Confidence Intervals
Cause of Death
Multivariate Analysis
Incidence

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Very long-term outcomes after percutaneous coronary intervention with bare metal stents for unprotected left main coronary artery disease. / Nomura, Akihiro; Yamaji, Kyohei; Shirai, Shinichi; Omata, Fumio; Soga, Yoshimitsu; Nagashima, Michio; Arita, Takeshi; Ando, Kenji; Sakai, Koyu; Goya, Masahiko; Yokoi, Hiroyoshi; Iwabuchi, Masashi; Nobuyoshi, Masakiyo.

In: EuroIntervention, Vol. 8, No. 8, 01.12.2012, p. 962-969.

Research output: Contribution to journalArticle

Nomura, A, Yamaji, K, Shirai, S, Omata, F, Soga, Y, Nagashima, M, Arita, T, Ando, K, Sakai, K, Goya, M, Yokoi, H, Iwabuchi, M & Nobuyoshi, M 2012, 'Very long-term outcomes after percutaneous coronary intervention with bare metal stents for unprotected left main coronary artery disease', EuroIntervention, vol. 8, no. 8, pp. 962-969. https://doi.org/10.4244/EIJV8I8A146
Nomura, Akihiro ; Yamaji, Kyohei ; Shirai, Shinichi ; Omata, Fumio ; Soga, Yoshimitsu ; Nagashima, Michio ; Arita, Takeshi ; Ando, Kenji ; Sakai, Koyu ; Goya, Masahiko ; Yokoi, Hiroyoshi ; Iwabuchi, Masashi ; Nobuyoshi, Masakiyo. / Very long-term outcomes after percutaneous coronary intervention with bare metal stents for unprotected left main coronary artery disease. In: EuroIntervention. 2012 ; Vol. 8, No. 8. pp. 962-969.
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T1 - Very long-term outcomes after percutaneous coronary intervention with bare metal stents for unprotected left main coronary artery disease

AU - Nomura, Akihiro

AU - Yamaji, Kyohei

AU - Shirai, Shinichi

AU - Omata, Fumio

AU - Soga, Yoshimitsu

AU - Nagashima, Michio

AU - Arita, Takeshi

AU - Ando, Kenji

AU - Sakai, Koyu

AU - Goya, Masahiko

AU - Yokoi, Hiroyoshi

AU - Iwabuchi, Masashi

AU - Nobuyoshi, Masakiyo

PY - 2012/12/1

Y1 - 2012/12/1

N2 - Aims: The aim of this study was to evaluate very long-term clinical outcomes and potential predictors after percutaneous coronary intervention (PCI) with bare metal stents (BMS) for unprotected left main coronary artery disease (ULMCAD). Methods and results: From March 1991 to August 2001, 151 patients who underwent PCI with BMS for ULMCAD were investigated retrospectively. The patient-oriented major adverse cardiac events (MACE) were defined as the occurrence of all-cause death, any MI, and any coronary revascularisation. The median follow-up duration was 10.5 years. The mean age was 69.9±11.5 years, and 106 patients (70.2%) were male. At 10 years, the incidences of cardiac death (CD), target lesion revascularisation (TLR) and patient-oriented MACE were 11.1%, 25.2% and 81.9%, respectively. In multivariate analysis, the pre-reference diameter of the left main trunk (LMT) was significantly associated with TLR (adjusted hazard ratio [HR] [95% confidence interval (CI)], 0.28 [0.14-0.54], p<0.001) and the SYNTAX score remained an independent predictor of patient-oriented MACE (adjusted HR [95% CI], 1.03 [1.007-1.05], p=0.009). Conclusions: The pre-reference diameter of LMT was significantly associated with TLR, and the SYNTAX score significantly predicted the risk of patient-oriented MACE at 10 years. BMS implantation for larger size of ULMCAD with a lower SYNTAX score was feasible for up to 10 years.

AB - Aims: The aim of this study was to evaluate very long-term clinical outcomes and potential predictors after percutaneous coronary intervention (PCI) with bare metal stents (BMS) for unprotected left main coronary artery disease (ULMCAD). Methods and results: From March 1991 to August 2001, 151 patients who underwent PCI with BMS for ULMCAD were investigated retrospectively. The patient-oriented major adverse cardiac events (MACE) were defined as the occurrence of all-cause death, any MI, and any coronary revascularisation. The median follow-up duration was 10.5 years. The mean age was 69.9±11.5 years, and 106 patients (70.2%) were male. At 10 years, the incidences of cardiac death (CD), target lesion revascularisation (TLR) and patient-oriented MACE were 11.1%, 25.2% and 81.9%, respectively. In multivariate analysis, the pre-reference diameter of the left main trunk (LMT) was significantly associated with TLR (adjusted hazard ratio [HR] [95% confidence interval (CI)], 0.28 [0.14-0.54], p<0.001) and the SYNTAX score remained an independent predictor of patient-oriented MACE (adjusted HR [95% CI], 1.03 [1.007-1.05], p=0.009). Conclusions: The pre-reference diameter of LMT was significantly associated with TLR, and the SYNTAX score significantly predicted the risk of patient-oriented MACE at 10 years. BMS implantation for larger size of ULMCAD with a lower SYNTAX score was feasible for up to 10 years.

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