Ostial and midshaft lesions vs. bifurcation lesions in 1111 patients with unprotected left main coronary artery stenosis treated with drug-eluting stents: results of the survey from the Italian Society of Invasive Cardiology

被引：105

作者：

Palmerini, Tullio ^{[1
]}

Sangiorgi, Diego ^{[1
]}

Marzocchi, Antonio ^{[1
]}

Tamburino, Corrado ^{[2
]}

Sheiban, Imad ^{[3
]}

Margheri, Massimo ^{[4
]}

Vecchi, Giuseppe ^{[5
]}

Sangiorgi, Giuseppe ^{[6
]}

Ruffini, Michele ^{[7
]}

Bartorelli, Antonio L. ^{[8
]}

Briguori, Carlo ^{[9
]}

Vignali, Luigi ^{[10
]}

Di Pede, Francesco ^{[11
]}

Ramondo, Angelo ^{[12
]}

Inglese, Luigi ^{[13
]}

De Carlo, Marco ^{[14
]}

Bolognese, Leonardo ^{[15
]}

Benassi, Alberto ^{[16
]}

Palmieri, Cataldo ^{[17
]}

Filippone, Vincenzo ^{[18
]}

Barlocco, Fabio ^{[19
]}

Lauria, Giulia ^{[1
]}

De Servi, Stefano ^{[19
]}

机构：

[1] Univ Bologna, Ist Cardiol, Policlin S Orsola, I-40138 Bologna, Italy

[2] Univ Catania, Dipartimento Cardiol, Osped Ferrarotto, Catania, Italy

[3] Univ Turin, Div Cardiol, Turin, Italy

[4] Univ Florence, Dipartimento Cardiovasc, Osped Careggi, Florence, Italy

[5] Osped S Maria Croci, Dipartimento Cardiol, Ravenna, Italy

[6] Ctr Emocolumbus, Milan, Italy

[7] Osped Infermi, Dipartimento Cardiol, Rimini, Italy

[8] Univ Milan, Ctr Cardiol Monzino, Milan, Italy

[9] Clin Mediterranea, Dipartimento Cardiol, Naples, Italy

[10] Univ Parma, Unita Operat Cardiol, Azienda Osped, I-43100 Parma, Italy

[11] Azienda Osped, Dipartimento Cardiol, Venice, Italy

[12] Univ Padua, Dipartimento Sci Cardiovasc, Padua, Italy

[13] IRCCS Policlin S Donato, Cardiovasc Intervent Radiol Dept, San Donato Milanese, Italy

[14] Osped Cisanello, Dipartimento Cardiotoracico, Pisa, Italy

[15] Osped S Donato, Dipartimento Cardiovasc, Arezzo, Italy

[16] Hesperia Hosp, Dipartimento Cardiol, Modena, Italy

[17] CNR, Ist Fisiol Clin, Massa, Italy

[18] Osped Cervello, Dipartimento Cardiovasc, Palermo, Italy

[19] Osped Civile, Dipartimento Malattie Cardiovasc, Legnaro, Italy

来源：

EUROPEAN HEART JOURNAL | 2009年 / 30卷 / 17期

关键词：

Stents; Bifurcations; Left main; BYPASS-SURGERY; IMPLANTATION; DISEASE; REGISTRY; INTERVENTION; ANGIOPLASTY;

D O I：

10.1093/eurheartj/ehp223

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In this study, we compared the cumulative risk of major adverse cardiac events (MACE) of patients with distal unprotected left main coronary artery (ULMCA) stenosis with those of patients with ostial and midshaft lesions treated with drug-eluting stent (DES). The survey promoted by the Italian Society of Invasive Cardiology on ULMCA stenosis was an observational study involving 19 high-volume Italian centres. We enrolled 1111 patients with ULMCA stenosis treated with DES. Major adverse cardiac events were defined as death, myocardial infarction, and target lesion revascularization. Three hundred and thirty-four patients had ostial or midshaft lesions (group 1) and 777 bifurcations (group 2). The adjusted hazards ratio of the risk of 2 year MACE of patients in group 2 vs. patients in group 1 was 1.50 (P = 0.024). However, we observed that there was a significant difference between patients with bifurcations treated with two stents and those in group 1 (P = 0.001), but not between patients with bifurcations treated with one stent and those in group 1 (P = 0.38). Patients with bifurcations have a worse outcome than patients with ostial and midshaft lesions. However, the technique used to treat bifurcations has a significant impact on clinical outcomes.

引用

页码：2087 / 2094

页数：8

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