This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Lee, J.-Y. Articles by Park, S.-J. PubMed Articles by Lee, J.-Y. Articles by Park, S.-J. Related Collections Related Article

INTERVENTIONAL CARDIOLOGY

Long-Term Clinical Outcomes of Sirolimus- Versus Paclitaxel-Eluting Stents for Patients With Unprotected Left Main Coronary Artery Disease

Analysis of the MAIN-COMPARE (Revascularization for Unprotected Left Main Coronary Artery Stenosis: Comparison of Percutaneous Coronary Angioplasty Versus Surgical Revascularization) Registry

Jong-Young Lee, MD^_*, Duk-Woo Park, MD, PhD^_*, Sung-Cheol Yun, PhD, Seung-Whan Lee, MD, PhD^_*, Young-Hak Kim, MD, PhD^_*, Cheol Whan Lee, MD, PhD^_*, Myeong-Ki Hong, MD, PhD^_*, Seong-Wook Park, MD, PhD^_* and Seung-Jung Park, MD, PhD^_*,_*

^_* Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Division of Biostatistics, Center for Medical Research and Information, University of Ulsan College of Medicine, Seoul, Korea

Manuscript received January 19, 2009; revised manuscript received April 6, 2009, accepted April 6, 2009.

^_* Reprint requests and correspondence: Dr. Seung-Jung Park, Department of Cardiology, University of Ulsan College of Medicine, Cardiac Center, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, Korea (Email: sjpark{at}amc.seoul.kr).

Objectives: The aim of this study was to evaluate long-term clinical outcomes after implantation of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) among patients with unprotected left main coronary artery (LMCA) disease.

Background: There have been few comparisons of long-term outcomes among currently available drug-eluting stents (DES) for the treatment of LMCA disease.

Methods: A total of 858 consecutive patients with unprotected LMCA stenosis were treated with SES (n = 669) or PES (n = 189) between May 2003 and June 2006. Primary outcome was the composite of death, myocardial infarction (MI), or target vessel revascularization (TVR).

Results: Baseline clinical and angiographic characteristics were similar in the 2 groups. During 3 years of follow-up, the adjusted risk of primary composite outcome was similar among the groups (SES vs. PES: 25.8% vs. 25.7%, hazard ratio [HR]: 0.95, 95% confidence interval [CI]: 0.64 to 1.41, p = 0.79). The 2 groups also showed a comparable adjusted rate of each component of outcome: death (9.1% vs. 11.0%, HR: 0.92, 95% CI: 0.47 to 1.80, p = 0.82), MI (8.1% vs. 8.0%, HR: 0.80, 95% CI: 0.43 to 1.48, p = 0.47), and TVR (12.1% vs. 10.6%, HR: 1.10, 95% CI: 0.53 to 2.29, p = 0.81). The 3-year rates of definite or probable stent thrombosis were 0.6% in the SES group and 1.6% in the PES group (adjusted p = 0.18).

Conclusions: In consecutive patients with unprotected LMCA disease undergoing DES implantation, SES and PES showed similar long-term clinical outcomes in terms of death, MI, repeat revascularization, and stent thrombosis.

Key Words: drug-eluting stent • left main coronary artery disease • PCI

Abbreviations and Acronyms   CABG = coronary artery bypass grafting   DES = drug-eluting stent(s)   LMCA = left main coronary artery   MI = myocardial infarction   PCI = percutaneous coronary intervention   PES = paclitaxel-eluting stent(s)   SES = sirolimus-eluting stent(s)   TVR = target vessel revascularization

Related Article

Inside This Issue
J. Am. Coll. Cardiol. 2009 54: A28. [Full Text] [PDF]