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Title: | A Randomized Comparison of Paclitaxel-Eluting Stents Versus Bare-Metal Stents for Treatment of Unprotected Left Main Coronary Artery Stenosis. | Authors: | Saltups A.;Zakke I.;Erglis A.;Narbute I.;Kumsars I.;Jegere S.;Mintale I.;Strazdins U. | Institution: | (Erglis, Narbute, Kumsars, Jegere, Mintale, Zakke, Strazdins) Latvian Center of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia (Saltups) Cabrini Medical Centre, Monash Medical Centre, Melbourne, Australia | Issue Date: | 17-Oct-2012 | Copyright year: | 2007 | Publisher: | Elsevier USA (6277 Sea Harbor Drive, Orlando FL 32862 8239, United States) | Place of publication: | United States | Publication information: | Journal of the American College of Cardiology. 50 (6) (pp 491-497), 2007. Date of Publication: 07 Aug 2007. | Abstract: | Objectives: To optimize percutaneous coronary intervention (PCI) strategy for unprotected left main (LM) disease, we performed a randomized study: intravascular ultrasound (IVUS)-guided bare-metal stent (BMS) or paclitaxel-eluting stent (PES) implantation after lesion pre-treatment with cutting balloon (CB) for unprotected LM lesions. Background(s): Recent studies have shown promising results in terms of safety and feasibility for patients with LM disease who underwent PCI with stent implantation. However, comparison of BMS and PES for LM lesions has not yet been evaluated. Method(s): One hundred three patients were randomly assigned to receive BMS (n = 50) or PES (n = 53) implantation. All interventions were IVUS guided, and CB pre-treatment before stenting was performed in all patients. All patients were scheduled for 6-month follow-up. Result(s): Baseline clinical characteristics were comparable in both cohorts. Stent implantation was successful in all lesions. Follow-up analysis showed binary restenosis in 11 (22%) BMS and in 3 (6%) PES patients (p = 0.021). By IVUS, percentage of neointimal volume obstruction at 6 months was reduced from 25.20 +/- 22.02% with BMS to 16.60 +/- 17.25% with PES (p = 0.02). At 6 months, the major adverse cardiac event-free survival rate was 70% in BMS and 87% in PES patients (p = 0.036). Conclusion(s): This study demonstrates that PCI of LM with IVUS guidance and CB pre-treatment is safe and effective. No serious procedure-related complications were observed, and clinical outcomes appeared to be good. Finally, the findings demonstrate that implantation of PES may be superior to BMS in the large-diameter LM vessel at 6 months, warranting the performance of a large-scale randomized trial. © 2007 American College of Cardiology Foundation. | DOI: | http://monash.idm.oclc.org/login?url=http://dx.doi.org/10.1016/j.jacc.2007.03.055 | PubMed URL: | 17678730 [http://www.ncbi.nlm.nih.gov/pubmed/?term=17678730] | ISSN: | 0735-1097 | URI: | https://repository.monashhealth.org/monashhealthjspui/handle/1/31811 | Type: | Article | Subjects: | artery diameter artery intima proliferation article clinical trial controlled clinical trial controlled study *coronary artery obstruction/dt [Drug Therapy] *coronary artery obstruction/th [Therapy] *coronary stent drug eluting stent female follow up heart infarction/co [Complication] human intermethod comparison intravascular ultrasound left coronary artery major clinical study male *percutaneous coronary intervention priority journal randomized controlled trial risk assessment safety stent survival rate technical aid clopidogrel/dt [Drug Therapy] clopidogrel/pd [Pharmacology] fibrinogen receptor antagonist/dt [Drug Therapy] fibrinogen receptor antagonist/pd [Pharmacology] heparin/dt [Drug Therapy] heparin/pd [Pharmacology] low molecular weight heparin/dt [Drug Therapy] low molecular weight heparin/pd [Pharmacology] *paclitaxel/ct [Clinical Trial] *paclitaxel/pd [Pharmacology] *rapamycin/ct [Clinical Trial] *rapamycin/pd [Pharmacology] bare metal stent cutting balloon paclitaxel eluting stent outcomes research adult aged female follow up heart infarction / complication human intermethod comparison intravascular ultrasound left coronary artery major clinical study male outcomes research *percutaneous coronary intervention priority journal randomized controlled trial risk assessment safety stent survival rate artery diameter aged technical aid artery intima proliferation article clinical trial controlled clinical trial controlled study *coronary artery obstruction / *drug therapy / *therapy *coronary stent drug eluting stent adult |
Type of Clinical Study or Trial: | Randomised controlled trial |
Appears in Collections: | Articles |
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