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Study finds support for PCI in unprotected left main disease
Date:3/31/2008

significant difference in mortality may support PCI as an alternative option to bypass surgery, said Seung-Jung Park, MD, PhD, director of interventional cardiology at Asan Medical Center, Seoul, Korea. It is also worth noting that most of patients treated with drug-eluting stents who need target vessel revascularization can be treated with subsequent PCI, without significant increase of death or serious complications.

For the study, Dr. Park and his colleagues analyzed data from 2,240 patients with unprotected left main coronary artery disease treated at 12 medical centers in Korea. Of these, 318 were treated with bare-metal stents, 784 were treated with drug-eluting stents, and 1,138 underwent bypass surgery. During three years of follow-up, patients treated with bare-metal stents were nearly 11 times as likely to need a repeat procedure to reopen the target vessel when compared to those who underwent bypass surgery. However, the rates of death (hazard ratio: 1.04) and the combined rates of death, heart attack and stroke (hazard ratio: 0.86) were similar in the two groups. Patients treated with drug-eluting stents were nearly six times as likely to need a repeat procedure during three years of follow-up, but the rates of death (hazard ratio 1.36) and the combined rates of death, heart attack and stroke (hazard ratio: 1.40) were statistically similar, although there was a trend toward higher event rates with drug-eluting stents.

The next step is to test the studys findings in a more rigorous clinical trial, Dr. Park said. Based on these observations, a randomized trial comparing PCI with drug-eluting stents and CABG is warranted in patients with unprotected left main disease who are candidates for revascularization, he said. However, unprotected left main stenting should not be attempted in clinical practice before the physician has achieved specialized experiences.

Dr. Park will present the results of the Revascularization for Unprotect
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Contact: Kathy Boyd David
pr@scai.org
717-422-1181
Weber Shandwick Worldwide
Source:Eurekalert

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