Objectives: The purpose of this study was to investigate the long-term safety and efficacy of percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation for unprotected left main coronary artery (ULMCA) disease. Background: Long-term clinical outcomes after DES implantation for ULMCA disease have not yet been ascertained. Methods: From April 2002 to April 2004, 358 consecutive patients who underwent PCI with DES implantation for de novo lesions on ULMCA were retrospectively selected and analyzed in 7 European and U.S. tertiary care centers. No patients were excluded from the analysis, and all patients had a minimum follow-up of 3 years. Results: Technical success rate was 100%. Procedural success rate was 89.6%. After 3 years, major adverse cardiovascular events (MACE)-free survival in the whole population was 73.5%. According to the Academic Research Consortium definitions, cardiac death occurred in 9.2% of patients, and reinfarction, target lesion revascularization (TLR), and target vessel revascularization (TVR) occurred in 8.6%, 5.8%, and 14.2% of patients, respectively. Definite stent thrombosis occurred in 2 patients (specifically at 0 and 439 days). In elective patients, the 3-year MACE-free survival was 74.2%, with mortality, reinfarction, TLR, and TVR rates of 6.2%, 8.3%, 6.6%, and 16%, respectively. In the emergent group the 3-year MACE-free survival was 68.2%, with mortality, reinfarction, TLR, and TVR rates of 21.4%, 10%, 2.8%, and 7.1%, respectively. Conclusions: Routine DES implantation in ULMCA disease seems encouraging, with favorable long-term clinical results.

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Persistent URL dx.doi.org/10.1016/j.jacc.2008.03.020, hdl.handle.net/1765/29761
Meliga, E, Garcia-Garcia, H.M, Valgimigli, M, Chieffo, A, Biondi-Zoccai, G.G, Maree, A.O, … Serruys, P.W.J.C. (2008). Longest Available Clinical Outcomes After Drug-Eluting Stent Implantation for Unprotected Left Main Coronary Artery Disease. The DELFT (Drug Eluting stent for LeFT main) Registry. Journal of the American College of Cardiology, 51(23), 2212–2219. doi:10.1016/j.jacc.2008.03.020