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Everolimus-Eluting Stent Implantation for Unprotected Left Main Coronary Artery Stenosis : The PRECOMBAT-2 (Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease) Study

Authors
 Young-Hak Kim  ;  Duk-Woo Park  ;  Jung-Min Ahn  ;  Sung-Cheol Yun  ;  Hae Geun Song  ;  Jong-Young Lee  ;  Won-Jang Kim  ;  Soo-Jin Kang  ;  Seung-Whan Lee  ;  Cheol Whan Lee  ;  Seong-Wook Park  ;  Yangsoo Jang  ;  Myung-Ho Jeong  ;  Hyo-Soo Kim  ;  Seung-Ho Hur  ;  Seung-Woon Rha  ;  Do-Sun Lim  ;  Sung-Ho Her  ;  Ki Bae Seung  ;  In-Whan Seong  ;  Seung-Jung Park 
Citation
 JACC-CARDIOVASCULAR INTERVENTIONS, Vol.5(7) : 708-717, 2012 
Journal Title
JACC-CARDIOVASCULAR INTERVENTIONS
ISSN
 1936-8798 
Issue Date
2012
MeSH
Confidence Intervals ; Coronary Artery Bypass ; Coronary Restenosis/drug therapy* ; Coronary Restenosis/surgery ; Coronary Restenosis/therapy ; Coronary Vessels/pathology ; Drug-Eluting Stents* ; Everolimus ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Immunosuppressive Agents/therapeutic use* ; Incidence ; Male ; Middle Aged ; Risk ; Sirolimus/administration & dosage ; Sirolimus/analogs & derivatives* ; Sirolimus/therapeutic use*
Keywords
bypass surgery ; coronary disease ; left main coronary disease ; stents
Abstract
OBJECTIVES:
This study sought to evaluate the safety and efficacy of second-generation drug-eluting stents (DES) for patients with unprotected left main coronary artery (ULMCA) stenosis.
BACKGROUND:
The clinical benefit of second-generation DES for ULMCA stenosis has not been determined.
METHODS:
The authors assessed 334 consecutive patients who received everolimus-eluting stents (EES) for ULMCA stenosis between 2009 and 2010. The 18-month incidence rates of major adverse cardiac or cerebrovascular events (MACCE), including death, myocardial infarction (MI), stroke, or ischemia-driven target vessel revascularization (TVR), were compared with those of a randomized study comparing patients who received sirolimus-eluting stents (SES) (n = 327) or coronary artery bypass grafts (CABG) (n = 272).
RESULTS:
EES (8.9%) showed a comparable incidence of MACCE as SES (10.8%; adjusted hazard ratio [aHR] of EES: 0.84; 95% confidence interval [CI]: 0.51 to 1.40; p = 0.51) and CABG (6.7%, aHR of EES: 1.40; 95% CI: 0.78 to 2.54; p = 0.26). The composite incidence of death, MI, or stroke also did not differ among patients receiving EES (3.3%), SES (3.7%; aHR of EES: 0.63; 95% CI: 0.27 to 1.47; p = 0.29), and CABG (4.8%; aHR of EES: 0.67; 95% CI: 0.29 to 1.54; p = 0.34). However, the incidence of ischemia-driven TVR in the EES group (6.5%) was higher than in the CABG group (2.6%, aHR of EES: 2.77; 95% CI: 1.17 to 6.58; p = 0.02), but comparable to SES (8.2%, aHR of EES: 1.14; 95% CI: 0.64 to 2.06; p = 0.65). Angiographic restenosis rates were similar in the SES and EES groups (13.8% vs. 9.2%, p = 0.16).
CONCLUSIONS:
Second-generation EES had a similar 18-month risk of MACCE for ULMCA stenosis as first-generation SES or CABG.
Files in This Item:
T201205919.pdf Download
DOI
22814775
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/90587
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