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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

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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.

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Acknowledgements

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

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Authors and Affiliations

  1. Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan

    Hirooki Higami & Takeshi Kimura

  2. Japanese Red Cross Society Wakayama Medical Centre, Wakayama, Japan

    Mamoru Toyofuku, Euihong Ko & Takashi Tamura

  3. Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan

    Takeshi Morimoto

  4. Kurashiki Central Hospital, Kurashiki, Japan

    Masanobu Ohya, Yasushi Fuku & Kazushige Kadota

  5. Kokura Memorial Hospital, Kokura, Japan

    Kyohei Yamaji, Hiromi Muranishi, Yuhei Yamaji & Kenji Ando

  6. Chikamori Hospital, Kochi, Japan

    Koji Nishida, Daisuke Furukawa & Kazuya Kawai

  7. Shizuoka General Hospital, Shizuoka, Japan

    Tomohisa Tada & Hiroki Sakamoto

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  1. Hirooki Higami
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Correspondence to Takeshi Kimura.

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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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Higami, H., Toyofuku, M., Morimoto, T. et al. 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. Cardiovasc Interv and Ther 33, 350–359 (2018). https://doi.org/10.1007/s12928-017-0497-2

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