ABSTRACT
Background: Percutaneous coronary intervention (PCI) has been increasingly employed to treat unprotected left main (ULM) stenosis, with hard endpoints similar to by-pass surgery, in patients selected by a Heart Team. Methods: From January 2008 to December 2011, 317 unselected and consecutive patients with de novo ULM stenosis underwent PCI with both bare metal (BMS) and drug-eluting (DES) stents. Major adverse cardiovascular events, target lesion (TLR) and vessel (TVR) revascularization were evaluated over a mean period of 590 ± 371 days. Results: Our population was characterized by a mean age 72 ± 10 years, high rate of acute coronary syndrome (ACS) (either with ST or non-ST elevation myocardial infarction, 15.5% and 35% respectively), severe comorbidity 16%, mean Euroscore 7 ± 3, mean Syntax Score 25 ± 9. In-hospital mortality was 6%. During the follow-up period, all-cause mortality was 16.7%, falling to 7% at the end of the follow-up, excluding patients presenting with ACS. TLR was observed and treated in 15% of patients. BMS utilization, age >75 years, ACS indication, Syntax Score >32 and associated peripheral artery disease were independent predictors of mortality at multivariate analysis. Conclusions: Stenting of ULM stenosis appears to be associated with a favorable mid-term outcome, even in an unselected population.
Share and Cite:
Varani, E. , Vecchio, S. , Aquilina, M. , Vecchi, G. , Balducelli, M. , Frassineti, V. and Margheri, M. (2013) Percutaneous treatment of
de novo unprotected left main stenosis in unselected consecutive patients: Experience of a high volume center.
World Journal of Cardiovascular Diseases,
3, 419-427. doi:
10.4236/wjcd.2013.37066.