PROGNOSIS OF UNPROTECTED LEFT MAIN CORONARY ARTERY STENTING AND THE FACTORS AFFECTING THE OUTCOMES IN CHINESE

作     者：GAO Run-lin XU Bo CHEN Ji-lin HAN Ya-ling LI Zhan-quan LUE Shu-zheng QI Xiao-yong HUO Yong WANG Le-feng CHEN Jun-zhu SHEN Wei-feng FANG Wei-yi JIA San-qing 

作者机构：on behalf of Chinese Registry of Unprotected Left Main Coronary Artery Stenting investigators 

出 版 物：《Chinese Medical Journal》 (中华医学杂志（英文版）)

年 卷 期：2006年第119卷第1期

页      面：14-20页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：stenting left main coronary artery prognosis 

摘      要：Background The long term prognosis of unprotected left main coronary artery （LMCA） stenting is controversial This study was conducted to evaluate the immediate and long term outcomes of LMCA stenting in Chinese patients and to determine which factors affect the outcomes. Methods From May 1997 to March 2003, 224 patients in 23 hospitals underwent elective unprotected LMCA stenting with bare metal stents. Their clinical records were analysed to ascertain immediate and long term outcomes of LMCA stenting as well as factors influencing the prognosis. Results Stents were implanted into LMCA successfully in 223 cases （99.6 %）. One death （0.5%） and one case of non-Q wave nonfatal myocardial infarction （MI） occurred in hospital. The mean follow-up time was （15.6±12.3） months. Cardiac death developed in 10 cases （4.5%）, noncardiac death in 2 cases （0.9%）, nonfatal MI in 4 cases （1.8%）, target lesion revascularization （TLR） of LMCA in 26 cases （11.7%） and TLR of nonLMCA in 37 cases （16.5%）. Univariate analysis showed that cardiac death correlated with left ventricular ejection fraction （LVEF 〈 40%）, female gender and LMCA combined with multivessel disease; that major adverse cardiac events （MACE） correlated with LVEF 〈 40%, bifurcation lesion and incomplete revascularization. Logistic regression analysis revealed that LVEF 〈 40% and female gender were independent predictors of cardiac death and MACE. Follow-up angiography was performed in 102 cases （45.7%）. The restenosis rate was 31.4%. Conclusions Long-term outcomes of stenting for selected patients with unprotected LMCA stenosis is acceptable. It should be performed in inoperable or low risk patients with LVEF ≥40% and isolated LMCA disease or LMCA combined with multivessel diseases in whom complete revascularization can be obtained.