Display Settings:

Format

Send to:

Choose Destination
Int J Cardiol. 2013 Dec 10;170(2):227-32. doi: 10.1016/j.ijcard.2013.10.060. Epub 2013 Oct 25.

Proximal coronary artery intervention: stent thrombosis, restenosis and death.

Author information

  • 1Department of Cardiology, Örebro University Hospital, Örebro, Sweden.

Abstract

BACKGROUND:

Percutaneous coronary intervention (PCI) of lesions in the proximal left anterior descending coronary artery (LAD) may confer a worse prognosis compared with the proximal right coronary artery (RCA) and left circumflex coronary artery (LCX).

METHODS:

From May 2005, to May 2011 we identified all PCIs for proximal, one-vessel coronary artery disease in the Swedish Coronary Angiography and Angioplasty Registry (SCAAR). We evaluated restenosis, stent thrombosis (ST) and mortality in the LAD as compared to the RCA and LCX according to stent type, bare metal (BMS) or drug-eluting stents (DES).

RESULTS:

7840 single vessel proximal PCI procedures were identified. Mean follow-up time was 792 days. No differences in restenosis or ST were seen between the LAD and the RCA. The frequency of restenosis and ST was higher in the proximal LAD compared to the proximal LCX (restenosis: hazard ratio (HR) 2.28, confidence interval (CI) 1.56-3.34 p<0.001; ST: HR 2.32, CI 1.11-4.85 p=0.024). We found no difference in mortality related to coronary artery. In the proximal LAD, DES implantation was associated with a lower restenosis rate (HR 0.39, CI 0.27-0.55 p<0.001) and mortality (HR 0.58, CI 0.41-0.82 p=0.002) compared with BMS. In the proximal RCA and LCX, DES use was not associated with lower frequency of clinical restenosis or mortality.

CONCLUSIONS:

Following proximal coronary artery intervention restenosis was more frequent in the LAD than in the LCX. Solely in the proximal LAD we found DES use to be associated with a lower risk of restenosis and death weighted against BMS.

© 2013.

KEYWORDS:

Angioplasty; Coronary artery disease; Drug-eluting stents

PMID:
24211065
[PubMed - in process]
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Full text links

    Icon for Elsevier Science
    Loading ...
    Write to the Help Desk