Two-year clinical outcomes in stable angina and acute coronary syndrome after percutaneous coronary intervention of left main coronary artery disease
1
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding longterm clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years). We evaluated clinical and angiographic characteristics and major adverse cardiac events (MACE) during 2-year clinical follow-up. Results: Mean age of studied patients was 64 ± 10 years with 339 male patients. Average stent diameter was 3.6 ± 0.4 mm and stent length was 19.7 ± 6.3 mm. Stent implantation techniques and use of intravascular ultrasound guidance were not different between two groups. In-hospital mortality was 0% in group I and 7% in group II (p = 0.035). One-month mortality was 0% in group I and 7.7% in group II (p = 0.968). Two-year survival rate was 93% in the group I and 88.4% in the group II (p = 0.921). Predictive factors for 2-year MACE were hypertension, Killip class ≥ 3, and use of intra-aortic balloon pump by multivariate analysis. Conclusions: Although in-hospital mortality rate was higher in ACS than in SAP, clinical outcomes during 2-year clinical follow-up were similar between SAP and ACS after PCI of ULMCA.
Abstract
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding longterm clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years). We evaluated clinical and angiographic characteristics and major adverse cardiac events (MACE) during 2-year clinical follow-up. Results: Mean age of studied patients was 64 ± 10 years with 339 male patients. Average stent diameter was 3.6 ± 0.4 mm and stent length was 19.7 ± 6.3 mm. Stent implantation techniques and use of intravascular ultrasound guidance were not different between two groups. In-hospital mortality was 0% in group I and 7% in group II (p = 0.035). One-month mortality was 0% in group I and 7.7% in group II (p = 0.968). Two-year survival rate was 93% in the group I and 88.4% in the group II (p = 0.921). Predictive factors for 2-year MACE were hypertension, Killip class ≥ 3, and use of intra-aortic balloon pump by multivariate analysis. Conclusions: Although in-hospital mortality rate was higher in ACS than in SAP, clinical outcomes during 2-year clinical follow-up were similar between SAP and ACS after PCI of ULMCA.
참고문헌 (18)
- El-Menyar AA, "Left main coronary artery stenosis: state-of-the-art", Curr Probl Cardiol, 32, pp.103~193 (2007)
- Black A, "Unprotected left main coronary artery stenting: correlates of midterm survival and impact of patient selection", J Am Coll Cardiol, 37, pp.832~838 (2001)
- Waller BF, "Atherosclerotic and nonatherosclerotic coronary artery factors in acute myocardial infarction", Cardiovasc Clin, 20, pp.29~104 (1989)
- Gomez-Lara J, "Global risk score for choosing the best revascularization strategy in patients with unprotected left main stenosis", J Invasive Cardiol, 25, pp.650~658 (2013)
- Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS), "Guidelines on myocardial revascularization", Eur Heart J, 31, pp.2501~2555 (2010)
- Patel MR, "ACCF", SCAI, AATS, pp.AHA, ASNC[DOI]
- Cheng CI, "Long-term outcomes of intervention for unprotected left main coronary artery stenosis: coronary stenting vs coronary artery bypass grafting", Circ J, 73, pp.705~712 (2009)
- Cheng CI, "Clinical presentation and prognostic factors of patients with acute ST-segment elevation myocardial infarction following emergent revascularization for left main coronary artery obstruction", Circ J, 72, pp.1598~1604 (2008)
- Cheng CI, "Feasibility and safety of transradial stenting for unprotected left main coronary artery stenoses", Circ J, 71, pp.855~861 (2007)
- Montalescot G, "Unprotected left main revascularization in patients with acute coronary syndromes", Eur Heart J, 30, pp.2308~2317 (2009)
- Silvestri M, "Unprotected left main coronary artery stenting: immediate and medium-term outcomes of 140 elective procedures", J Am Coll Cardiol, 35, pp.1543~1550 (2000)
- 심두선, "Effectiveness of Drug-Eluting Stents versus Bare-Metal Stents in Large Coronary Arteries in Patients with Acute Myocardial Infarction", Journal of Korean Medical Science, 26(4), pp.521~527 (2011), 대한의학회
- Karjalainen PP, "Long-term clinical outcome with titanium-nitride-oxide-coated stents and paclitaxel-eluting stents for coronary revascularization in an unselected population", Int J Cardiol, 144, pp.42~46 (2010)
- Ferrante G, "Percutaneous coronary intervention versus bypass surgery for left main coronary artery disease: a meta-analysis of randomised trials", EuroIntervention, 7, pp.738~746 (2011)
- Sim DS, "Clinical outcome of unprotected left main coronary artery disease in patients with acute myocardial infarction", Int Heart J, 54, pp.185~191 (2013)
- Fajadet J, "Current management of left main coronary artery disease", Eur Heart J, 33, pp.36~50 (2012)
- Naik H, "A meta-analysis of 3,773 patients treated with percutaneous coronary intervention or surgery for unprotected left main coronary artery stenosis", JACC Cardiovasc Interv, 2, pp.739~747 (2009)
- Palmerini T, "Impact of acute coronary syndromes on two-year clinical outcomes in patients with unprotected left main coronary artery stenosis treated with drug-eluting stents", Am J Cardiol, 105, pp.174~178 (2010)
