- 期刊
Comparison of Bare-Metal Stent and Drug-Eluting Stent for the Treatment of Patients Undergoing Percutaneous Coronary Intervention for Unprotected Left Main Coronary Artery Disease- Long-Term Result from a Single Center Experience
並列摘要
Background: Percutaneous coronary intervention (PCI) has become an alternative treatment for left main (LM) coronary artery disease. The aim of our study was to compare long-term clinical outcomes of patients undergoing unprotected LMPCI with bare-metal stent (BMS) or drug-eluting stent (DES) in a high-risk population. Methods and Results: We enrolled 223 consecutive patients with unprotected LM coronary artery disease undergoing PCI (mean age: 71.1 ± 11.2 years, 187 male), including 94 patients receiving BMS and 129 patients receiving DES. The patients receiving DES had a significantly higher SYNTAX score (p=0.05). During the mean follow-up period of 2.5 years, there were 31 cardiovascular deaths (BMS: 21 cases, DES: 10 cases, p=0.04 by log-rank test), 56 major adverse cardiovascular events (MACE, including cardiovascular death, non-fatal myocardial infarction (MI) and clinical-driven target lesion revascularization; BMS: 33 cases, DES: 23 cases, p=0.03 by log-rank test) and 6 cases with definite/probable stent thrombosis (BMS: 5 cases, DES: 1 cases, p=0.09). Inmultivariate Cox analysis, the use of DES was identified as an independent protective factor against cardiovascular death [hazard ratio (HR)=0.34, 95% confidence interval (Cl)=0.15-0.79, p=0.01] and MACE (HR=0.50, 95% CI=0.28-0.88, p=0.02). The clinical outcome analyses in propensity-scorematched the cohort (87 matched pair of patients receiving BMS and DES) and yielded similar results. Conclusions: In the general practice among a high-risk population undergoing unprotected LMPCI, the use of DES appeared to be beneficial in reducing the risk of long-term cardiovascular death and MACE.
延伸閱讀
- Sung, S. H., Chen, T. C., Cheng, H. M., Lee, J. C., Lang, H. C., & Chen, C. H. (2017). Comparison of Clinical Outcomes in Patients Undergoing Coronary Intervention with Drug-Eluting Stents or Bare-Metal Stents: A Nationwide Population Study. Acta Cardiologica Sinica, 33(1), 10-19. https://doi.org/10.6515/ACS20160608A
- 林宜玲（2006）。Resources Utilization and Clinical Outcomes of Drug-Eluting Stent versus Bare Metal Stent in Coronary Artery Disease Patients〔碩士論文，高雄醫學大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0011-0407200616133200
- Chang, H. H., Hung, C. F., Chen, I. C., Wu, P. C., Liu, L. W., & Fang, C. C. (2021). Long-Term Clinical Outcomes of New-Generation Drug-Eluting Stents in Coronary Artery Disease: A Real-World Observational Study. Acta Cardiologica Sinica, 37(5), 484-495. https://doi.org/10.6515/ACS.202109_37(5).20210426A
- Liu, C. C., Wang, J. Y., Yen, I. P., & Lai, C. J. (2011). One-Year Follow-Up after Percutaneous Coronary Intervention with Titanium-Nitride-Oxide-Coated Stents Versus Paclitaxel-Eluting Stents in Patients from Real-World Clinical Practice. Acta Cardiologica Sinica, 27(2), 94-100. https://www.airitilibrary.com/Article/Detail?DocID=10116842-201106-201107070022-201107070022-94-100
- Tsai, M. L., Hsieh, M. J., Chen, C. C., Chang, S. H., Wang, C. Y., Chen, D. Y., Yang, C. H., Yeh, J. K., Ho, M. Y., & Hsieh, I. C. (2020). Comparison of 9-Month Angiographic Follow-Up and Long-Term Clinical Outcomes of Biodegradable Polymer Drug-Eluting Stents and Second-Generation Durable Polymer Drug-Eluting Stents in Patients Undergoing Single Coronary Artery Stenting. Acta Cardiologica Sinica, 36(2), 97-104. https://doi.org/10.6515/ACS.202003_36(2).20190729A