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Clinical outcomes of double stent strategy for unprotected left main distal bifurcation lesions using current generation drug eluting stent comparing to early generation drug eluting stent; The Milan and New Tokyo ( MITO ) registry
Author(s) -
Watanabe Yusuke,
Mitomo Satoru,
Naganuma Toru,
Kawamoto Hiroyoshi,
Takagi Kensuke,
Chieffo Alaide,
Carlino Mauro,
Montorfano Matteo,
Nakamura Sunao,
Colombo Antonio
Publication year - 2021
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.28962
Subject(s) - medicine , percutaneous coronary intervention , drug eluting stent , conventional pci , stent , myocardial infarction , cardiology , population , target lesion , ostium , mace , surgery , environmental health
Background There are only little data available on the comparison of clinical outcomes between a early generation drug eluting stent (eDES) and a current generation drug eluting stent (cDES) for percutaneous coronary intervention (PCI) with double stent strategy (DSS) for unprotected distal left main disease (ULMD). Methods Between April 2005 and December 2015, we recruited 452 consecutive ULMD patients treated with DSS (eDES, 236 patients; cDES, 216 patients). In this study, eDES included Cipher, Taxus, and Endeavor and cDES included Ultimaster, Resolute family, Xience family, Promus family, Synergy, and Nobori. The primary endpoint was target lesion failure (TLF) defined as a composite of cardiac death, target lesion revascularization (TLR) and myocardial infarction (MI) during the median follow‐up period of 1,809(IQR: 1,190–2,510) days. Results In entire population, the rate of overall TLR was significantly lower in cDES group than that in eDES group (adjusted HR 0.62, 95% CI 0.40–0.96, p = .032). The rate of TLR for the ostium of LCX was significantly lower in cDES group than that in eDES group (adjusted HR 0.63, 95% CI 0.39–0.99, p = .047). Cardiac mortality, the rate of TLR for LM‐LAD, MI and definite/probable ST did not significantly differ between both groups. The results were preserved in the propensity adjusted population. Conclusions cDES significantly improved the clinical outcomes in population treated with DSS mainly driven by the reduction of TLR for the ostium of LCX.