Key result
Left main PCI with Stentys DES links ACS to ~13% higher absolute MACCE versus stable angina.
Observational (n=175)
Yes
Left main PCI using a self-apposing drug-eluting stent showed favorable 1-year clinical outcomes in patients with stable angina, but higher rates of MACCE and stent thrombosis in those presenting with acute coronary syndrome.
Favorable 1-year outcomes in stable LM PCI support device evaluation; leaves open ACS safety and thrombosis risk in registry data.
BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.
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Wańha et al. (2018) conducted an observational in left main coronary artery disease (n=175). self-apposing Stentys drug-eluting stent was evaluated on 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. Left main PCI using a self-apposing Stentys DES resulted in a 1-year MACCE rate of 3.4% in patients with stable angina and 16.2% in those with acute coronary syndrome.
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