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Use of drug-eluting stents for unprotected left main coronary artery disease is associated with "favorable" long-term clinical outcomes, according to a report.

Use of drug-eluting stents (DES) for unprotected left main coronary artery (ULMCA) disease is associated with "favorable" long-term clinical outcomes, according to a report in the June 10th issue of the Journal of the American College Cardiology.

Dr. Patrick W. Serruys and colleagues aimed to "generate the longest available follow-up data" for interventions with drug-eluting stents in this setting. Using the Drug Eluting stent for LeFT main (DELFT) registry, they assessed the outcomes of 358 consecutive patients who underwent DES implantation for ULMCA disease from April 2002 to April 2004 at seven European and US centers. The minimum follow-up period was three years.

The technical and procedural success rates were 100 per cent and 89.6 per cent, respectively, the report indicates.

After three years, 73.5 per cent of all patients were alive and had not experienced any major adverse cardiovascular events, Dr. Serruys, from Erasmus Medical Center in Rotterdam, the Netherlands, and colleagues state. The corresponding percentage in elective patients was 74.2 per cent and in emergent patients, 68.2 per cent.

The proportions of all patients experiencing cardiac death, reinfarction, target lesion revascularization, and target vessel revascularization were 9.2 per cent, 8.6 per cent, 5.8 per cent, and 14.2 per cent, respectively. The corresponding percentages in elective patients were 6.2 per cent, 8.3 per cent, 6.6 per cent, and 16 per cent and in emergent patients, 21.4 per cent, 10 per cent, 2.8 per cent, and 7.1 per cent.

Stent thrombosis was confirmed in two patients at zero and 439 days, the authors note.

"Very-long-term follow-up of patients with ULMCA disease treated with DES demonstrated a satisfactory rate in both single and composite outcomes. The progressive reduction of incidence of adverse events over time suggests that DES are persistently effective," Dr. Serruys' team concludes.

J Am Coll Cardiol 2008;51:2212-2219