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Cardiovascular Intervention and Therapeutics

, Volume 33, Issue 4, pp 350–359 | Cite as

Impact of previous drug-eluting stent restenosis in non-left main coronary artery lesions on long-term outcomes after left main coronary artery stenting: an observation from the AOI-LMCA registry

  • Hirooki Higami
  • Mamoru Toyofuku
  • Takeshi Morimoto
  • Masanobu Ohya
  • Yasushi Fuku
  • Kyohei Yamaji
  • Hiromi Muranishi
  • Yuhei Yamaji
  • Koji Nishida
  • Daisuke Furukawa
  • Tomohisa Tada
  • Euihong Ko
  • Kenji Ando
  • Hiroki Sakamoto
  • Takashi Tamura
  • Kazuya Kawai
  • Kazushige Kadota
  • Takeshi Kimura
  • On Behalf of the AOI LMCA Stenting Registry Investigators
Original Article
  • 87 Downloads

Abstract

We hypothesized that patients who had previous target-lesion revascularization (TLR) for DES restenosis in non-left main coronary artery (LMCA) lesions might have a higher risk for restenosis after subsequent DES implantation for a de novo unprotected LMCA lesion. Among 1809 patients enrolled in the Assessing Optimal Percutaneous Coronary Intervention for LMCA (AOI-LMCA) registry, which is a retrospective 6-centre registry of consecutive patients undergoing LMCA stenting in Japan, 251 patients with previous DES implantation for non-LMCA lesions were subdivided into the 2 groups with (N = 56) or without (N = 195) previous TLR in non-LMCA lesions. The risk for TLR for LMCA was neutral between the prior TLR for DES restenosis group and the no prior TLR for DES restenosis group [hazard ratio (HR) 0.99, 95% confidence interval (CI) 0.44–2.02, P = 0.98]. The risks for both TLR caused by restenosis of the LMCA main branch, and second TLR for restenosis after first TLR for LMCA were also neutral between the 2 groups (HR 0.42, 95% CI 0.10–1.25, P = 0.13, and HR 0.59, 95% CI 0.03–3.63, P = 0.60, respectively). In conclusion, prior TLR for DES restenosis in non-LMCA lesions was not associated with worse long-term clinical outcomes after DES implantation for de novo unprotected LMCA lesions.

Clinical Trial Registration: Assessing Optimal Percutaneous Coronary Intervention for Left Main Coronary Artery Stenting Registry (AOI LMCA Stenting Registry). http://www.umin.ac.jp/ctr/index/htm/. Unique Identifier: UMIN000014706.

Keywords

Left main coronary artery Coronary stenting Repeat revascularization Drug-eluting stent Target-lesion revascularization Restenosis 

Notes

Acknowledgements

We thank the members of the catheterization laboratories and physicians of the participating centres.

Compliance with ethical standards

Conflict of interest

Takeshi Kimura serves as an advisory board member for Abbott Vascular. The other authors report no conflicts of interest in regards to this manuscript.

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Copyright information

© Japanese Association of Cardiovascular Intervention and Therapeutics 2017

Authors and Affiliations

  • Hirooki Higami
    • 1
  • Mamoru Toyofuku
    • 2
  • Takeshi Morimoto
    • 3
  • Masanobu Ohya
    • 4
  • Yasushi Fuku
    • 4
  • Kyohei Yamaji
    • 5
  • Hiromi Muranishi
    • 5
  • Yuhei Yamaji
    • 5
  • Koji Nishida
    • 6
  • Daisuke Furukawa
    • 6
  • Tomohisa Tada
    • 7
  • Euihong Ko
    • 2
  • Kenji Ando
    • 5
  • Hiroki Sakamoto
    • 7
  • Takashi Tamura
    • 2
  • Kazuya Kawai
    • 6
  • Kazushige Kadota
    • 4
  • Takeshi Kimura
    • 1
  • On Behalf of the AOI LMCA Stenting Registry Investigators
  1. 1.Department of Cardiovascular Medicine, Graduate School of MedicineKyoto UniversityKyotoJapan
  2. 2.Japanese Red Cross Society Wakayama Medical CentreWakayamaJapan
  3. 3.Department of Clinical EpidemiologyHyogo College of MedicineNishinomiyaJapan
  4. 4.Kurashiki Central HospitalKurashikiJapan
  5. 5.Kokura Memorial HospitalKokuraJapan
  6. 6.Chikamori HospitalKochiJapan
  7. 7.Shizuoka General HospitalShizuokaJapan

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