Five-year outcomes after stenting of unprotected left main coronary artery stenosis in patients with normal left ventricular function

Background: We analyzed the long-term (5-year) outcome of patients treated with stenting for unprotected left main coronary artery (LMCA) stenosis. Methods: Between January 1995 and September 2001, 187 consecutive patients with unprotected LMCA stenosis and normal left ventricular function underwent elective stenting. Patients were examined or interviewed after 1, 3 and 6 months, and every 4 months thereafter for the occurrence of major adverse cardiac events (MACE), including death, myocardial infarction (MI) and target lesion revascularization (TLR). Results: The procedural success rate was 99.5%. During hospitalization, there were no deaths and only one stent thrombosis. Six-month angiography in 162 patients (follow-up rate, 86.6%) showed a restenosis rate of 33.3%. During 5-year follow-up, there were 13 deaths (6 cardiac, 7 noncardiac) and 2 nonfatal MI. TLRs were required in 36 (20.9%) patients and new lesion revascularizations were required in 13 (5.0%) patients. At 1, 3 and 5 years, the cumulative probabilities for freedom from MACE were 79.9 ± 1.8%, 77.5 ± 2.5% and 77.5 ± 2.5%, respectively. Conclusion: The initial favorable outcomes of patients with normal left ventricular function after stenting of unprotected LMCA stenosis were sustained for up to 5 years.