Impact of lesion morphology and associated procedures for left main coronary stenting on angiographic outcome after inte
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ORIGINAL ARTICLE
Impact of lesion morphology and associated procedures for left main coronary stenting on angiographic outcome after intervention: sub-analysis of Heart Research Group of Kanazawa, HERZ, Study Masa-aki Kawashiri • Kenji Sakata • Katsuharru Uchiyama • Tetsuo Konno • Masanobu Namura • Sumio Mizuno • Ryozo Tatami • Honin Kanaya • Yutaka Nitta • Ichiro Michishita • Hiroaki Hirase • Kosei Ueda • Takashi Aoyama • Kazuyasu Okeie • Tatsuo Haraki • Kiyoo Mori • Tsutomu Araki • Masaharu Minamoto • Hisanori Oiwake Hidekazu Ino • Kenshi Hayashi • Masakazu Yamagishi
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Received: 30 January 2013 / Accepted: 17 October 2013 Ó Japanese Association of Cardiovascular Intervention and Therapeutics 2013
Abstract Whether the lesion morphology and associated interventional procedures for the left main coronary artery disease (LMCA) could affect clinical outcome is still controversial. Therefore, we examined the impact of lesion morphology and associated procedures on clinical and angiographic outcomes of stenting for the LMCA. Among 7,660 patients with coronary intervention registered, we analyzed early angiographic results of 228 patients (179 men, mean age 69.4 years) concerned with LMCA lesions. In 121 out of 228 patients having long-term angiographic results, we examined the occurrence of major adverse coronary events (MACE) particularly in terms of the M. Kawashiri, K. Sakata and K. Uchiyama equally contributed to establishing the preset work in terms of interventional procedures, case enrollment and data analysis. M. Kawashiri K. Sakata K. Uchiyama T. Konno H. Ino K. Hayashi M. Yamagishi (&) Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, 13-1 Takara-machi, Kanazawa, Ishikawa 920-8641, Japan e-mail: [email protected] M. Namura H. Kanaya K. Ueda K. Mori T. Araki M. Minamoto H. Oiwake HERZ Group, Kanazawa, Ishikawa, Japan S. Mizuno R. Tatami T. Aoyama HERZ Group, Fukui, Fukui, Japan Y. Nitta H. Hirase K. Okeie T. Haraki HERZ Group, Toyama, Toyama, Japan I. Michishita HERZ Group, Yokohama, Kanagawa, Japan
presence of acute coronary syndrome (ACS), the kind of stents, bear metal or drug eluting, the lesion morphology and associated procedures. Early angiographic success rate of LMCA stenting was 100 %, and clinical success rate was 94.3 %. During follow-up period for 3 years, MACE was observed in 17 patients. Under these conditions, multiple stenting (p \ 0.01) and complicated procedures such as such as Y-stent, T-stent and crush stent (p \ 0.01) were listed as risks for MACE, although there was no statistical difference in kinds of stent. Multivariate analysis demonstrated the significant disadvantage of complicated procedures using the bear metal stent on the occurrence of MACE (p \ 0.01). These results demonstrate that the complicated procedures have great impact on clinical and angiographic outcomes after stenting for LMCA lesions, and suggest the simple procedure with a single stent for LMCA lesions in the present cohort. Whethe
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