Abstract and Introduction
Abstract
Aims: To evaluate the occurrence of late and very late stent thrombosis (ST) following elective drug-eluting stent (DES) implantation in unprotected left main coronary artery (LMCA) stenosis in a large multicentre registry.
Methods and Results: All 731 consecutive patients who had sirolimus- or paclitaxel-eluting stent electively implanted in de novo lesions on unprotected LMCA in five centres were included. ST was defined according to Academic Research Consortium definitions. Four (0.5%) patients had a definite ST: three early (two acute and one subacute) and one late ST, no cases of very late definite ST were recorded. All patients survived from the event. Three patients had a probable ST. Therefore, 7/731 (0.95%) patients had a definite or a probable ST and all were on dual antiplatelet therapy at the time of the event. Possible (eight late and 12 very late) ST occurred in 20 (2.7%) patients. At 29.5 ± 13.7 months follow-up, a total of 45 (6.2%) patients had died; 31 (4.2%) of cardiac death. Ninety five (12.9%) patients had a target-vessel and 76 (10.4%) a target-lesion revascularization. Angiographic follow-up was performed in 548 patients (75%): restenosis occurred in 77 (14.1%) patients.
Conclusion: Elective treatment of LMCA stenosis with DES appears safe with a 0.9% incidence of definite and probable ST at 29.5 ± 13.7 months.
Introduction
Some concerns have recently been raised regarding the risk of late and very late stent thrombosis (ST) following drug-eluting stent (DES) implantation. Registry data of percutaneous coronary interventions (PCI) with DES use in unprotected left main coronary artery (LMCA) lesions showed that, at mid-term clinical follow-up, this is a feasible and safe approach. To date, no study has specifically addressed the prevalence and predictors of late and very late ST following elective DES implantation in unprotected LMCA lesions. The aim of the present study is therefore to evaluate the occurrence of late and very late ST following elective DES implantation in unprotected LMCA stenosis in a large multicentre registry.