Outcomes of Percutaneous Coronary Intervention with
Second Generation Drug-Eluting Stents in Patients with
Unprotected Left Main Coronary Artery Disease
Tassanawiwat W, MD¹, Wongvipaporn C, MD², Mahavanakul W, MD¹, Thanakitcharu P, MD¹,
Sookananchai B, MD³, Preeyanon P, MD⁴, Kanphakdee T, MS¹, Udayachalerm W, MD⁵
Affiliation : ¹ Sunpasitthiprasong Hospital, Ubon Ratchathani, Thailand ² Division of Cardiology, Medicine, Khon Kaen University, Khon Kaen, Thailand ³ Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand ⁴ Piyavate Hospital, Bangkok, Thailand ⁵ King Chulalongkorn Memorial Hospital, Bangkok, Thailand
Background: Patients with unprotected left main coronary artery disease (ULMCA) have a high mortality risk. Coronary artery
bypass graft (CABG) had been the standard treatment for several decades. However, percutaneous coronary intervention (PCI)
with drug-eluting stents (DES) is increasingly used as an alternative treatment.
Objective: To evaluate the safety and efficacy of second-generation drug-eluting stents in patients with ULMCA.
Materials and Methods: One hundred eighty-nine consecutive patients with ULMCA underwent PCI with second generation biolimus-eluting stents in three centers in the northeast region of Thailand. The primary end point was major adverse cardiac or cerebrovascular events (MACCE), which is a composite of all causes of mortality, myocardial infarction (MI), target vessel revascularization, and stroke.
Results: In a median follow-up of 43.0±3.6 months, MACCE occurred in 24.3% (46/189) of patients. In all causes of death, which occurred in 16.9% (32/189) of patients, there were 5.8% (11/189) of cardiac deaths and 11.1% (21/189) of non-cardiac deaths. There were 2.1% (4/189) MI and 7.4% (14/189) target vessel revascularization. No stroke occurred in the present study. Definite stent thrombosis occurred in three patients (1.6%).
Conclusion: PCI with second generation biolimus-eluting stents is considered acceptable as an alternative treatment in its safety and efficacy in patients with ULMCA.
Keywords : Unprotected left main coronary artery disease (ULMCA), Percutaneous coronary intervention (PCI), Drug eluting
stent (DES)
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