Positive results for unprotected left main coronary artery PCI with drug-eluting stents

June 22, 2011

Patients with normal left ventricular function who undergo elective unprotected left main coronary artery (ULMCA) percutaneous coronary intervention (PCI) with drug-eluting stents (DES) had favorable outcomes according to new research. Results of the multicenter, retrospective study are reported in the June issue of Catheterization and Cardiovascular Interventions, a journal published by Wiley-Blackwell on behalf of The Society for Cardiovascular Angiography and Interventions (SCAI).

For patients with ULMCA disease, grafting (CABG), known commonly as heart bypass surgery, is the standard of care based on medical evidence that shows a survival advantage with this intervention. Current guidelines for PCI state that ULMCA stenting may be an option for patients who are at high risk for adverse surgical outcomes, but have a low risk for procedural complications. In patients with severe aortic calcification, cerebrovascular disease, or limited life expectancy angioplasty may be elected over .

The present study, led by Michael Lee, MD, FSCAI, from the University of California, Los Angeles (UCLA) Medical Center evaluated the safety and efficacy of ULMCA PCI with DES in patients with normal left ventricular function. Researchers used data from a multicenter international registry, identifying 221 patients who underwent elective PCI for ULMCA disease between 2002 and 2009. Patients in the study had a mean age of 68 years and 75% were male; 25% had diabetes, 39% had a history of heart attack, and 40% had a prior PCI.

"Our analysis confirms that elective PCI with DES in patients with normal left ventricular function is a safe and effective treatment for ULMCA disease," said Dr. Lee. In the first 30 days following angioplasty no cardiac death, target lesion revascularization (TLR), , or stroke were reported. While no cases of Q-wave occurred, seven patients had periprocedural myocardial infarction.

The authors found that event-free survival estimates for cardiac death and TLR at five years was 96% and 89%, respectively. Further analysis established that patient age of 75 years or older and a history of myocardial infarction were independent predictors of cardiac death. "Research comparing the safety and efficacy of ULMCA PCI with DES versus CABG are needed and results from a large multicenter trial are forthcoming." Dr Lee concluded, "ULMCA PCI may be a viable option for low-risk patients with normal left ventricular function."

Explore further: Elevated protein levels in cardiac muscles could predict mortality following angioplasty

More information: "Long-Term Outcomes of Elective Drug-Eluting Stenting of the Unprotected Left Main Coronary Artery in Patients with Normal Left Ventricular Function." Michael S. Lee, Tae Yang, Giuseppe Biondi-Zoccai, Dario Sillano, Enrico Cerrato, Giuseppe Tarantini, Jola Xhaxho, Joseph Aragon and Imad Sheiban. Catheterization and Cardiovascular Interventions; Published Online: April 8, 2011 (DOI: 10.1002/ccd.22777); Print Issue Date: June 2011. http://onlinelibrary.wiley.com/doi/10.1002/ccd.22777/abstract

Related Stories

Elevated protein levels in cardiac muscles could predict mortality following angioplasty

May 13, 2011
New research shows that elevated levels of cardiac troponin T (cTnT) or I (cTnI) in patients who had angioplasty indicate a higher risk of all-cause mortality and long-term adverse events such as heart attack. Routine monitoring ...

Recommended for you

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.