Long-Term Clinical Outcomes of Unprotected Left Main Percutaneous Coronary Intervention: A Large Single-Centre Experience. (12th January 2021)

• Record Type: Journal Article
• Authors: Gao, Lijian; Gao, Zhan; Song, Ying; Guan, Changdong; Xu, Bo; Chen, Jue; Liu, Haibo; Qin, Xuewen; Yao, Min; Yuan, Jinqing; Wu, Yongjian; Hu, Fenghuan; Qian, Jie; Tang, Yida; Dou, Kefei; Yang, Weixian; Qiu, Hong; Mu, Chaowei; Dai, Jun; Qiao, Shubin; Chen, Jilin; Gao, Runlin; Yang, Yuejin
• Other Names: El-Jack Seif S. Academic Editor.
• Is Part Of: Journal of interventional cardiology. Volume 2021(2021)
• Publication Date: 2021-01-12
• Subjects: Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.1206
• DOI: 10.1155/2021/8829686
• Languages: English
• ISSNs: 0896-4327

Abstract

Abstract : Aims . This study sought to report the 10-year clinical outcomes of patients who underwent unprotected left main (LM) percutaneous coronary intervention (PCI) in a large centre. Methods and Results . A total of 913 consecutive patients who underwent unprotected LM PCI from January 2004 to December 2008 at Fu Wai Hospital were retrospectively analysed; the mean age was 60.0 ± 10.9 years, females accounted for 22% of patients, diabetes was present in 27.7% of patients, and an LM bifurcation lesion occurred in 82.9% of patients. During the median follow-up of 9.7 years, major adverse cardiac or cerebrovascular events (MACCEs) occurred in 25.6% (234) of patients, and the rates of all-cause death, myocardial infarction, and stroke were 14.9%, 11.0%, and 7.1%, respectively. Cardiac death occurred in only 7.9% of patients. The estimated event rate was 41.9% for death/myocardial infarction/any revascularization and 45.9% for death/MI/stroke/any revascularization. Definite/probable stent thrombosis occurred in 4.3% (39) of patients. According to the subgroup analysis, IVUS-guided PCI was associated with less long-term MACCEs. Further multivariate analysis identified that age and LVEF<40% were the only independent predictors for 10-year death. Age, LVEF<40%, creatinine clearance, and incomplete revascularization were independent predictors for death/MI, while a two-stent strategy, diabetes, a transradial approach, and the use of bare metal stents (BMSs) or first-generation drug-eluting stents (DESs) were not. Conclusions . Unprotected LM PCI in a large cohort of consecutive patients in a single large centre demonstrated favourable long-term outcomes up to 10 years even with the use of BMSs and first-generation of DESs.