Impact of previous drug-eluting stent restenosis in non-left main coronary artery lesions on long-term outcomes after le
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ORIGINAL ARTICLE
Impact of previous drug‑eluting stent restenosis in non‑left main coronary artery lesions on long‑term outcomes after left main coronary artery stenting: an observation from the AOI‑LMCA registry Hirooki Higami1 · Mamoru Toyofuku2 · Takeshi Morimoto3 · Masanobu Ohya4 · Yasushi Fuku4 · Kyohei Yamaji5 · Hiromi Muranishi5 · Yuhei Yamaji5 · Koji Nishida6 · Daisuke Furukawa6 · Tomohisa Tada7 · Euihong Ko2 · Kenji Ando5 · Hiroki Sakamoto7 · Takashi Tamura2 · Kazuya Kawai6 · Kazushige Kadota4 · Takeshi Kimura1 · On Behalf of the AOI LMCA Stenting Registry Investigators Received: 2 July 2017 / Accepted: 10 October 2017 © Japanese Association of Cardiovascular Intervention and Therapeutics 2017
Abstract We hypothesized that patients who had previous target-lesion revascularization (TLR) for DES restenosis in non-left main coronary artery (LMCA) lesions might have a higher risk for restenosis after subsequent DES implantation for a de novo unprotected LMCA lesion. Among 1809 patients enrolled in the Assessing Optimal Percutaneous Coronary Intervention for LMCA (AOI-LMCA) registry, which is a retrospective 6-centre registry of consecutive patients undergoing LMCA stenting in Japan, 251 patients with previous DES implantation for non-LMCA lesions were subdivided into the 2 groups with (N = 56) or without (N = 195) previous TLR in non-LMCA lesions. The risk for TLR for LMCA was neutral between the prior TLR for DES restenosis group and the no prior TLR for DES restenosis group [hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.44–2.02, P = 0.98]. The risks for both TLR caused by restenosis of the LMCA main branch, and second TLR for restenosis after first TLR for LMCA were also neutral between the 2 groups (HR 0.42, 95% CI 0.10–1.25, P = 0.13, and HR 0.59, 95% CI 0.03–3.63, P = 0.60, respectively). In * Takeshi Kimura [email protected]‑u.ac.jp 1
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara‑cho, Sakyo‑ku, Kyoto 606‑8507, Japan
2
Japanese Red Cross Society Wakayama Medical Centre, Wakayama, Japan
3
Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan
4
Kurashiki Central Hospital, Kurashiki, Japan
5
Kokura Memorial Hospital, Kokura, Japan
6
Chikamori Hospital, Kochi, Japan
7
Shizuoka General Hospital, Shizuoka, Japan
conclusion, prior TLR for DES restenosis in non-LMCA lesions was not associated with worse long-term clinical outcomes after DES implantation for de novo unprotected LMCA lesions. Clinical Trial Registration: Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry (AOI LMCA Stenting Registry). http://www.umin.ac.jp/ctr/index/htm/. Unique Identifier: UMIN000014706. Keywords Left main coronary artery · Coronary stenting · Repeat revascularization · Drug-eluting stent · Target-lesion revascularization · Restenosis
Introduction Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has brought about favourable long-term
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