Drug-eluting stent in left main coronary artery disease decreases risk of cardiovascular events
21 aug 2009-- Implantation of a drug-eluting stent following percutaneous coronary intervention for unprotected left main coronary artery disease (ULMCA) decreases the risk of cardiovascular events and stroke compared to a bare-metal stent, according to a study published online Aug. 19 in the Journal of the American College of Cardiology.
Pawel E. Buszman, M.D., of Medical University of Silesia in Katowice, Poland, and colleagues followed up 252 patients from the Left Main Coronary Artery Stenting Registry who underwent percutaneous coronary intervention and stenting for ULMCA between 1997 and 2008. Bare-metal stents were used in 158 patients and drug-eluting stents in 94 patients. The researchers looked at major adverse cardiovascular and cerebral events (MACCE) at 30 days, one year, and long-term (one to 11 years, mean of 3.8 years). The researchers found that 12 patients suffered a MACCE during the 30-day period following percutaneous coronary intervention, including four deaths. At one-year, restenosis had occurred in 17 patients, while over the long term, there were 64 MACCE incidents and 35 deaths. The authors further note that there was a significantly lower incidence of MACCE in drug-eluting stent patients compared to bare-metal stent patients (14.9 and 25.9 percent, respectively). "A drug-eluting stent implantation for ULMCA decreases the risk of long-term MACCE and particularly improves survival in patients with distal ULMCA disease. These findings are encouraging and support the need for long-term follow-up of patients with ULMCA randomized to drug-eluting stent or coronary artery bypass grafting in large trials," the authors write.
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