Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis: Comparison with bare metal stent implantation

Seung Jung Park, Young Hak Kim, Bong Ki Lee, Seung Whan Lee, Cheol Whan Lee, Myeong Ki Hong, Jae Joong Kim, Gary S. Mintz, Seong Wook Park

Research output: Contribution to journalArticle

395 Citations (Scopus)

Abstract

This study was designed to compare the clinical and angiographic outcomes of sirolimus-eluting stent (SES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (LMCA) stenosis. The safety and effectiveness of SES implantation for unprotected LMCA stenosis have not been ascertained. Elective SES implantation for de novo unprotected LMCA stenosis was performed in 102 consecutive patients with preserved left ventricular function from March 2003 to March 2004. Data from this group were compared to those from 121 patients treated with BMS during the preceding two years. Compared to the BMS group, the SES group received more direct stenting, had fewer debulking atherectomies, had a greater number of stents, had more segments stented, and underwent more bifurcation stenting. The procedural success rate was 100% for both groups. There were no incidents of death, stent thrombosis, Q-wave myocardial infarction (MI), or emergent bypass surgery during hospitalization in either group. Despite less acute gain (2.06 ± 0.56 mm vs. 2.73 ± 0.73 mm, p < 0.001) in the SES group, SES patients showed a lower late lumen loss (0.05 ± 0.57 mm vs. 1.27 ± 0.90 mm, p < 0.001) and a lower six-month angiographic restenosis rate (7.0% vs. 30.3%, p < 0.001) versus the BMS group. At 12 months, the rate of freedom from death, MI, and target lesion revascularization was 98.0 ± 1.4% in the SES group and 81.4 ± 3.7% in the BMS group (p = 0.0003). Sirolimus-eluting stent implantation for unprotected LMCA stenosis appears safe with regard to acute and midterm complications and is more effective in preventing restenosis compared to BMS implantation.

Original languageEnglish
Pages (from-to)351-356
Number of pages6
JournalJournal of the American College of Cardiology
Volume45
Issue number3
DOIs
Publication statusPublished - 2005 Feb 1

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Coronary Stenosis
Sirolimus
Stents
Metals
Myocardial Infarction
Atherectomy
Left Ventricular Function

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Park, Seung Jung ; Kim, Young Hak ; Lee, Bong Ki ; Lee, Seung Whan ; Lee, Cheol Whan ; Hong, Myeong Ki ; Kim, Jae Joong ; Mintz, Gary S. ; Park, Seong Wook. / Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis : Comparison with bare metal stent implantation. In: Journal of the American College of Cardiology. 2005 ; Vol. 45, No. 3. pp. 351-356.
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abstract = "This study was designed to compare the clinical and angiographic outcomes of sirolimus-eluting stent (SES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (LMCA) stenosis. The safety and effectiveness of SES implantation for unprotected LMCA stenosis have not been ascertained. Elective SES implantation for de novo unprotected LMCA stenosis was performed in 102 consecutive patients with preserved left ventricular function from March 2003 to March 2004. Data from this group were compared to those from 121 patients treated with BMS during the preceding two years. Compared to the BMS group, the SES group received more direct stenting, had fewer debulking atherectomies, had a greater number of stents, had more segments stented, and underwent more bifurcation stenting. The procedural success rate was 100{\%} for both groups. There were no incidents of death, stent thrombosis, Q-wave myocardial infarction (MI), or emergent bypass surgery during hospitalization in either group. Despite less acute gain (2.06 ± 0.56 mm vs. 2.73 ± 0.73 mm, p < 0.001) in the SES group, SES patients showed a lower late lumen loss (0.05 ± 0.57 mm vs. 1.27 ± 0.90 mm, p < 0.001) and a lower six-month angiographic restenosis rate (7.0{\%} vs. 30.3{\%}, p < 0.001) versus the BMS group. At 12 months, the rate of freedom from death, MI, and target lesion revascularization was 98.0 ± 1.4{\%} in the SES group and 81.4 ± 3.7{\%} in the BMS group (p = 0.0003). Sirolimus-eluting stent implantation for unprotected LMCA stenosis appears safe with regard to acute and midterm complications and is more effective in preventing restenosis compared to BMS implantation.",
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Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis : Comparison with bare metal stent implantation. / Park, Seung Jung; Kim, Young Hak; Lee, Bong Ki; Lee, Seung Whan; Lee, Cheol Whan; Hong, Myeong Ki; Kim, Jae Joong; Mintz, Gary S.; Park, Seong Wook.

In: Journal of the American College of Cardiology, Vol. 45, No. 3, 01.02.2005, p. 351-356.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sirolimus-eluting stent implantation for unprotected left main coronary artery stenosis

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AU - Park, Seung Jung

AU - Kim, Young Hak

AU - Lee, Bong Ki

AU - Lee, Seung Whan

AU - Lee, Cheol Whan

AU - Hong, Myeong Ki

AU - Kim, Jae Joong

AU - Mintz, Gary S.

AU - Park, Seong Wook

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N2 - This study was designed to compare the clinical and angiographic outcomes of sirolimus-eluting stent (SES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (LMCA) stenosis. The safety and effectiveness of SES implantation for unprotected LMCA stenosis have not been ascertained. Elective SES implantation for de novo unprotected LMCA stenosis was performed in 102 consecutive patients with preserved left ventricular function from March 2003 to March 2004. Data from this group were compared to those from 121 patients treated with BMS during the preceding two years. Compared to the BMS group, the SES group received more direct stenting, had fewer debulking atherectomies, had a greater number of stents, had more segments stented, and underwent more bifurcation stenting. The procedural success rate was 100% for both groups. There were no incidents of death, stent thrombosis, Q-wave myocardial infarction (MI), or emergent bypass surgery during hospitalization in either group. Despite less acute gain (2.06 ± 0.56 mm vs. 2.73 ± 0.73 mm, p < 0.001) in the SES group, SES patients showed a lower late lumen loss (0.05 ± 0.57 mm vs. 1.27 ± 0.90 mm, p < 0.001) and a lower six-month angiographic restenosis rate (7.0% vs. 30.3%, p < 0.001) versus the BMS group. At 12 months, the rate of freedom from death, MI, and target lesion revascularization was 98.0 ± 1.4% in the SES group and 81.4 ± 3.7% in the BMS group (p = 0.0003). Sirolimus-eluting stent implantation for unprotected LMCA stenosis appears safe with regard to acute and midterm complications and is more effective in preventing restenosis compared to BMS implantation.

AB - This study was designed to compare the clinical and angiographic outcomes of sirolimus-eluting stent (SES) and bare metal stent (BMS) implantation for unprotected left main coronary artery (LMCA) stenosis. The safety and effectiveness of SES implantation for unprotected LMCA stenosis have not been ascertained. Elective SES implantation for de novo unprotected LMCA stenosis was performed in 102 consecutive patients with preserved left ventricular function from March 2003 to March 2004. Data from this group were compared to those from 121 patients treated with BMS during the preceding two years. Compared to the BMS group, the SES group received more direct stenting, had fewer debulking atherectomies, had a greater number of stents, had more segments stented, and underwent more bifurcation stenting. The procedural success rate was 100% for both groups. There were no incidents of death, stent thrombosis, Q-wave myocardial infarction (MI), or emergent bypass surgery during hospitalization in either group. Despite less acute gain (2.06 ± 0.56 mm vs. 2.73 ± 0.73 mm, p < 0.001) in the SES group, SES patients showed a lower late lumen loss (0.05 ± 0.57 mm vs. 1.27 ± 0.90 mm, p < 0.001) and a lower six-month angiographic restenosis rate (7.0% vs. 30.3%, p < 0.001) versus the BMS group. At 12 months, the rate of freedom from death, MI, and target lesion revascularization was 98.0 ± 1.4% in the SES group and 81.4 ± 3.7% in the BMS group (p = 0.0003). Sirolimus-eluting stent implantation for unprotected LMCA stenosis appears safe with regard to acute and midterm complications and is more effective in preventing restenosis compared to BMS implantation.

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