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Stenting Left Main

Abstract

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Long-term outcomes after stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 10-year results of bare-metal stents and 5-year results of drug-eluting stents from the ASAN-MAIN (ASAN Medical Center-Left MAIN Revascularization) Registry Intravascular Ultrasound to Guide Left Main Stem Intervention: A Sub-Study of the NOBLE Trial Self-expandable sirolimus-eluting stents compared to second-generation drug-eluting stents for the treatment of the left main: A propensity score analysis from the SPARTA and the FAILS-2 registries Contemporary Use and Trends in Unprotected Left Main Coronary Artery Percutaneous Coronary Intervention in the United States: An Analysis of the National Cardiovascular Data Registry Research to Practice Initiative Impact of SYNTAX Score on 10-Year Outcomes After Revascularization for Left Main Coronary Artery Disease Comparative effectiveness analysis of percutaneous coronary intervention versus coronary artery bypass grafting in patients with chronic kidney disease and unprotected left main coronary artery disease Differences between the left main and other bifurcations Unprotected Left Main Disease: Indications and Optimal Strategies for Percutaneous Intervention
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Clinical Trial12 September 2017, [Epub ahead of print]

JOURNAL：Catheter Cardiovasc Interv. Article Link

Usefulness of the SYNTAX score II to validate 2-year outcomes in patients with complex coronary artery disease undergoing percutaneous coronary intervention: A large single-center study

Song Y, Gao Z, Tang X et al. Keywords: complex PCI; left main coronary disease; percutaneous coronary intervention; risk stratification

ABSTRACT

Objective - This study aimed to assess the prognostic ability of synergy between percutaneous coronary intervention with Taxus and cardiac surgery score II (SS-II) in a large cohort of patients with complex coronary artery disease (CAD) undergoing percutaneous coronary intervention (PCI) in clinical practice.


Background - Few studies have explored the usefulness of SS-II in nonrandomized clinical patients with complex CAD undergoing temporary PCI.


Methods - We prospectively enrolled 4398 consecutive patients undergoing three-vessel and/or unprotected left main PCI in a single center from January 2013 to December 2013. Patients were stratified according to SS-II for PCI tertiles as follows: SS-II ≤ 20 (n = 1474); SS-II 20-26 (n = 1462); and SS-II > 26 (n = 1462). The predictive ability for 2-year mortality was compared between angiographic scores and scores combining both angiographic and clinical variables.


Results - Mortality was significantly higher in the upper tertile than in the intermediate or lower tertiles during the 2-year follow-up (2.7% vs 1.7% vs 0.5%, respectively; P < 0.001). Multivariate analysis showed that SS-II was an independent predictor of 2-year mortality (hazard ratio: 1.66, 95% confidence interval: 1.03-2.68; P = 0.04). After adjusting for multivariable factors, SS-II had better prediction of 2-year mortality than baseline SS (C-index: SS-II = 0.740 vs baseline SS = 0.620; P < 0.001).


Conclusions - As a risk score combining both anatomical and clinical variables, SS-II demonstrated superiority compared with the purely angiographic SS to predict 2-year mortality in a clinical population of patients with severe CAD undergoing temporary PCI.
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