Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents

Young Hak Kim; Duk Woo Park; Seung Whan Lee; Sung Cheol Yun; Cheol Whan Lee; Myeong Ki Hong; Seong Wook Park; Ki Bae Seung; Hyeon Cheol Gwon; Myung Ho Jeong; Yangsoo Jang; Hyo Soo Kim; In Whan Seong; Hun Sik Park; Taehoon Ahn; In Ho Chae; Seung Jea Tahk; Wook Sung Chung; Seung Jung Park

doi:10.1161/CIRCULATIONAHA.108.800805

Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents

Young Hak Kim, Duk Woo Park, Seung Whan Lee, Sung Cheol Yun, Cheol Whan Lee, Myeong Ki Hong, Seong Wook Park, Ki Bae Seung, Hyeon Cheol Gwon, Myung Ho Jeong, Yangsoo Jang, Hyo Soo Kim, In Whan Seong, Hun Sik Park, Taehoon Ahn, In Ho Chae, Seung Jea Tahk, Wook Sung Chung, Seung Jung Park

Department of Internal Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND - Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). METHODS AND RESULTS - In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P=0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P=0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P=0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P=0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P=0.024) lesions with a comparable risk of death or myocardial infarction. CONCLUSIONS - Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.

Original language	English
Pages (from-to)	400-407
Number of pages	8
Journal	Circulation
Volume	120
Issue number	5
DOIs	https://doi.org/10.1161/CIRCULATIONAHA.108.800805
Publication status	Published - 2009 Aug

All Science Journal Classification (ASJC) codes

Cardiology and Cardiovascular Medicine
Physiology (medical)

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This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1161/CIRCULATIONAHA.108.800805

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Kim, Y. H., Park, D. W., Lee, S. W., Yun, S. C., Lee, C. W., Hong, M. K., Park, S. W., Seung, K. B., Gwon, H. C., Jeong, M. H., Jang, Y., Kim, H. S., Seong, I. W., Park, H. S., Ahn, T., Chae, I. H., Tahk, S. J., Chung, W. S., & Park, S. J. (2009). Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents. Circulation, 120(5), 400-407. https://doi.org/10.1161/CIRCULATIONAHA.108.800805

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title = "Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents",

abstract = "BACKGROUND - Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). METHODS AND RESULTS - In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P=0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P=0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P=0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P=0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P=0.024) lesions with a comparable risk of death or myocardial infarction. CONCLUSIONS - Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.",

author = "Kim, {Young Hak} and Park, {Duk Woo} and Lee, {Seung Whan} and Yun, {Sung Cheol} and Lee, {Cheol Whan} and Hong, {Myeong Ki} and Park, {Seong Wook} and Seung, {Ki Bae} and Gwon, {Hyeon Cheol} and Jeong, {Myung Ho} and Yangsoo Jang and Kim, {Hyo Soo} and Seong, {In Whan} and Park, {Hun Sik} and Taehoon Ahn and Chae, {In Ho} and Tahk, {Seung Jea} and Chung, {Wook Sung} and Park, {Seung Jung}",

year = "2009",

month = aug,

doi = "10.1161/CIRCULATIONAHA.108.800805",

language = "English",

volume = "120",

pages = "400--407",

journal = "Circulation",

issn = "0009-7322",

publisher = "Lippincott Williams and Wilkins",

number = "5",

}

Kim, YH, Park, DW, Lee, SW, Yun, SC, Lee, CW, Hong, MK, Park, SW, Seung, KB, Gwon, HC, Jeong, MH, Jang, Y, Kim, HS, Seong, IW, Park, HS, Ahn, T, Chae, IH, Tahk, SJ, Chung, WS & Park, SJ 2009, 'Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents', Circulation, vol. 120, no. 5, pp. 400-407. https://doi.org/10.1161/CIRCULATIONAHA.108.800805

TY - JOUR

T1 - Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents

AU - Kim, Young Hak

AU - Park, Duk Woo

AU - Lee, Seung Whan

AU - Yun, Sung Cheol

AU - Lee, Cheol Whan

AU - Hong, Myeong Ki

AU - Park, Seong Wook

AU - Seung, Ki Bae

AU - Gwon, Hyeon Cheol

AU - Jeong, Myung Ho

AU - Jang, Yangsoo

AU - Kim, Hyo Soo

AU - Seong, In Whan

AU - Park, Hun Sik

AU - Ahn, Taehoon

AU - Chae, In Ho

AU - Tahk, Seung Jea

AU - Chung, Wook Sung

AU - Park, Seung Jung

PY - 2009/8

Y1 - 2009/8

N2 - BACKGROUND - Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). METHODS AND RESULTS - In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P=0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P=0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P=0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P=0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P=0.024) lesions with a comparable risk of death or myocardial infarction. CONCLUSIONS - Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.

AB - BACKGROUND - Limited information is available on long-term outcomes for patients with unprotected left main coronary artery disease who received drug-eluting stents (DES). METHODS AND RESULTS - In the multicenter registry evaluating outcomes among patients with unprotected left main coronary artery stenosis undergoing stenting with either bare metal stents (BMS) or DES, 1217 consecutive patients were divided into 2 groups: 353 who received only BMS and 864 who received at least 1 DES. The 3-year outcomes were compared by use of the adjustment of inverse-probability-of-treatment-weighted method. Patients receiving DES were older and had a higher prevalence of diabetes mellitus, hypertension, hyperlipidemia, and multivessel disease. In the overall population, with the use of DES, the 3-year adjusted risk of death (8.0% versus 9.5%; hazard ratio, 0.71; 95% confidence interval, 0.36 to 1.40; P=0.976) or death or myocardial infarction (14.3% versus 14.9%; hazard ratio, 0.83; 95% confidence interval, 0.49 to 1.40; P=0.479) was similar compared with BMS. However, the risk of target lesion revascularization was significantly lower with the use of DES than BMS (5.4% versus 12.1%; hazard ratio, 0.40; 95% confidence interval, 0.22 to 0.73; P=0.003). When patients were classified according to lesion location, DES was still associated with lower risk of target lesion revascularization in patients with bifurcation (6.9% versus 16.3%; hazard ratio, 0.38; 95% confidence interval, 0.18 to 0.78; P=0.009) or nonbifurcation (3.4% versus 10.3%; hazard ratio, 0.39; 95% confidence interval, 0.17 to 0.88; P=0.024) lesions with a comparable risk of death or myocardial infarction. CONCLUSIONS - Compared with BMS, DES was associated with a reduction in the need for repeat revascularization without increasing the risk of death or myocardial infarction for patients with unprotected left main coronary artery stenosis.

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DO - 10.1161/CIRCULATIONAHA.108.800805

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AN - SCOPUS:68249117983

SN - 0009-7322

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JO - Circulation

JF - Circulation

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ER -

Long-term safety and effectiveness of unprotected left main coronary stenting with drug-eluting stents compared with bare-metal stents

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