Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland.
First Department of Cardiology, Medical University of Gdańsk, Gdańsk, Poland.
Catheter Cardiovasc Interv. 2019 Mar 1;93(4):574-582. doi: 10.1002/ccd.27876. Epub 2018 Oct 11.
There is a paucity of data on left main (LM) percutaneous coronary intervention (PCI) therapy with dedicated DES platforms. The LM-STENTYS is a multicenter registry aimed at evaluating clinical outcome after PCI of LM performed with a self-apposing Stentys DES implantation.
The registry consists of 175 consecutive patients treated with Stentys DES implanted to LM. The primary endpoint was the composite of major adverse cardiac and cerebral events (MACCE) defined as cardiac death, myocardial infarction (MI), target lesion revascularization (TLR), and stroke assessed after 1 year. The secondary endpoint was stent thrombosis (ST) at 1 year.
The median age was 69 years (IQR, 62-78 years). Acute coronary syndrome (ACS) was the presenting diagnosis in 117 (66.9%) patients [74 (63.2%) unstable angina, 31 (26.5%) NSTEMI, 12 (10.3%) STEMI] and stable angina (SA) was present in 58 (33.1%) patients. The median SYNTAX score was 23.0 (IQR, 18.7-32.2) in the SA group and 25.0 (IQR, 20.0-30.7) in the ACS group. During 1-year follow-up in the SA group two (3.4%) MACCE occurred, both of them were cardiac deaths. In ACS patients there were 19 (16.2%) MACCE [9 (7.7%) cardiac deaths, 11 (9.4%) MIs, 11(9.4%) TLR, 1(0.9%) stroke]. Altogether, three (1.7%) cases of acute ST were noted, all of them in ACS subset.
LM PCI using self-apposing Stentys DES showed favorable clinical outcomes at 1-year in patients with SA. Events of ST in the ACS group warrant further research.
专用药物洗脱支架（DES）平台下左主干（LM）经皮冠状动脉介入治疗（PCI）的数据较为匮乏。LM-STENTYS 是一项多中心注册研究，旨在评估应用自对吻支架 Stentys DES 行 LM 介入治疗后的临床结果。
该注册研究共纳入 175 例连续接受 Stentys DES 治疗的 LM 病变患者。主要终点为 1 年时主要不良心脑血管事件（MACCE）的复合终点，定义为心脏死亡、心肌梗死（MI）、靶病变血运重建（TLR）和卒中。次要终点为 1 年时支架血栓形成（ST）。
中位年龄为 69 岁（IQR，62-78 岁）。117 例（66.9%）患者的首发诊断为急性冠脉综合征（ACS）[74 例（63.2%）不稳定型心绞痛，31 例（26.5%）非 ST 段抬高型心肌梗死，12 例（10.3%）ST 段抬高型心肌梗死]，58 例（33.1%）为稳定型心绞痛。SA 组的 SYNTAX 评分中位数为 23.0（IQR，18.7-32.2），ACS 组为 25.0（IQR，20.0-30.7）。在 SA 组的 1 年随访中，2 例（3.4%）发生 MACCE，均为心脏死亡。ACS 患者中有 19 例（16.2%）发生 MACCE[9 例（7.7%）心脏死亡，11 例（9.4%）MI，11 例（9.4%）TLR，1 例（0.9%）卒中]。ACS 亚组共有 3 例（1.7%）发生急性 ST，均为 ST。
在稳定型心绞痛患者中，应用自对吻支架 Stentys DES 的 LM PCI 在 1 年时显示出良好的临床结果。ACS 组中 ST 的发生事件需要进一步研究。
