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Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization. / Wiebe, Jens; Kuna, Constantin; Ibrahim, Tareq; Lösl, Martin; Cassese, Salvatore; Kufner, Sebastian; Schunkert, Heribert; Byrne, Robert A.; Laugwitz, Karl-Ludwig; Valgimigli, Marco; Richardt, Gert; Mehilli, Julinda; Kastrati, Adnan.

In: JACC. Cardiovascular interventions, Vol. 13, No. 19, 12.10.2020, p. 2266-2274.

Research output: Contribution to journalArticleAcademicpeer-review

Harvard

Wiebe, J, Kuna, C, Ibrahim, T, Lösl, M, Cassese, S, Kufner, S, Schunkert, H, Byrne, RA, Laugwitz, K-L, Valgimigli, M, Richardt, G, Mehilli, J & Kastrati, A 2020, 'Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization', JACC. Cardiovascular interventions, vol. 13, no. 19, pp. 2266-2274. https://doi.org/10.1016/j.jcin.2020.07.017

APA

Wiebe, J., Kuna, C., Ibrahim, T., Lösl, M., Cassese, S., Kufner, S., Schunkert, H., Byrne, R. A., Laugwitz, K-L., Valgimigli, M., Richardt, G., Mehilli, J., & Kastrati, A. (2020). Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization. JACC. Cardiovascular interventions, 13(19), 2266-2274. https://doi.org/10.1016/j.jcin.2020.07.017

Vancouver

Wiebe J, Kuna C, Ibrahim T, Lösl M, Cassese S, Kufner S et al. Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization. JACC. Cardiovascular interventions. 2020 Oct 12;13(19):2266-2274. https://doi.org/10.1016/j.jcin.2020.07.017

Author

Wiebe, Jens ; Kuna, Constantin ; Ibrahim, Tareq ; Lösl, Martin ; Cassese, Salvatore ; Kufner, Sebastian ; Schunkert, Heribert ; Byrne, Robert A. ; Laugwitz, Karl-Ludwig ; Valgimigli, Marco ; Richardt, Gert ; Mehilli, Julinda ; Kastrati, Adnan. / Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization. In: JACC. Cardiovascular interventions. 2020 ; Vol. 13, No. 19. pp. 2266-2274.

BibTeX

@article{c6a0ebfb1f1848d79f1bd8491604fc1b,
title = "Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization",
abstract = "Objectives: The aim of this study was to evaluate the prognostic impact of target lesion revascularization (TLR) of the unprotected left main coronary artery (ULMCA) after stent failure. Background: Although drug-eluting stents are safe and effective for treatment of the ULMCA, increased rates of repeat revascularization have been observed. Methods: This is a patient-level pooled analysis of the randomized ISAR-LEFT-MAIN (Drug-Eluting-Stents for Unprotected Left Main Stem Disease) and ISAR-LEFT-MAIN-2 (Drug-Eluting Stents to Treat Unprotected Coronary Left Main Disease) trials, in which patients underwent stenting of the ULMCA. The present analysis includes patients who underwent angiography during follow-up. Patients with TLR were compared with those without. Additional long-term clinical follow-up after TLR was conducted, and its influence on mortality was evaluated. Mortality was calculated using the Kaplan-Meier method. Predictors of mortality were assessed in a multivariate analysis. Results: A total of 1,001 patients were eligible, of whom 166 experienced TLR. The 5-year mortality rate was 30.2% in patients with TLR compared with 17.3% in those without TLR (p < 0.001). In the multivariate analysis, glomerular filtration rate (−30 ml/min; hazard ratio [HR]: 2.25; 95% confidence interval [CI]: 1.54 to 3.27; p < 0.001), chronic obstructive pulmonary disease (HR: 4.95; 95% CI: 1.33 to 18.42; p = 0.02), and body mass index (+5 kg/m2; HR: 1.61; 95% CI: 1.12 to 2.32; p = 0.01) were independent predictors of mortality after TLR due to left main stent failure. The type of repeat revascularization and the underlying stent did not influence the mortality after TLR of the ULMCA. Conclusions: Mortality after TLR for left main stent failure is high. Patient-related factors seem to have a greater impact on mortality after TLR than other variables.",
keywords = "coronary artery disease, in-stent restenosis, repeat revascularization, stent failure, unprotected left main stenosis",
author = "Jens Wiebe and Constantin Kuna and Tareq Ibrahim and Martin L{\"o}sl and Salvatore Cassese and Sebastian Kufner and Heribert Schunkert and Byrne, {Robert A.} and Karl-Ludwig Laugwitz and Marco Valgimigli and Gert Richardt and Julinda Mehilli and Adnan Kastrati",
year = "2020",
month = oct,
day = "12",
doi = "10.1016/j.jcin.2020.07.017",
language = "English",
volume = "13",
pages = "2266--2274",
journal = "JACC. Cardiovascular interventions",
issn = "1936-8798",
publisher = "Elsevier Inc.",
number = "19",

}

RIS

TY - JOUR

T1 - Long-Term Prognostic Impact of Restenosis of the Unprotected Left Main Coronary Artery Requiring Repeat Revascularization

AU - Wiebe, Jens

AU - Kuna, Constantin

AU - Ibrahim, Tareq

AU - Lösl, Martin

AU - Cassese, Salvatore

AU - Kufner, Sebastian

AU - Schunkert, Heribert

AU - Byrne, Robert A.

AU - Laugwitz, Karl-Ludwig

AU - Valgimigli, Marco

AU - Richardt, Gert

AU - Mehilli, Julinda

AU - Kastrati, Adnan

PY - 2020/10/12

Y1 - 2020/10/12

N2 - Objectives: The aim of this study was to evaluate the prognostic impact of target lesion revascularization (TLR) of the unprotected left main coronary artery (ULMCA) after stent failure. Background: Although drug-eluting stents are safe and effective for treatment of the ULMCA, increased rates of repeat revascularization have been observed. Methods: This is a patient-level pooled analysis of the randomized ISAR-LEFT-MAIN (Drug-Eluting-Stents for Unprotected Left Main Stem Disease) and ISAR-LEFT-MAIN-2 (Drug-Eluting Stents to Treat Unprotected Coronary Left Main Disease) trials, in which patients underwent stenting of the ULMCA. The present analysis includes patients who underwent angiography during follow-up. Patients with TLR were compared with those without. Additional long-term clinical follow-up after TLR was conducted, and its influence on mortality was evaluated. Mortality was calculated using the Kaplan-Meier method. Predictors of mortality were assessed in a multivariate analysis. Results: A total of 1,001 patients were eligible, of whom 166 experienced TLR. The 5-year mortality rate was 30.2% in patients with TLR compared with 17.3% in those without TLR (p < 0.001). In the multivariate analysis, glomerular filtration rate (−30 ml/min; hazard ratio [HR]: 2.25; 95% confidence interval [CI]: 1.54 to 3.27; p < 0.001), chronic obstructive pulmonary disease (HR: 4.95; 95% CI: 1.33 to 18.42; p = 0.02), and body mass index (+5 kg/m2; HR: 1.61; 95% CI: 1.12 to 2.32; p = 0.01) were independent predictors of mortality after TLR due to left main stent failure. The type of repeat revascularization and the underlying stent did not influence the mortality after TLR of the ULMCA. Conclusions: Mortality after TLR for left main stent failure is high. Patient-related factors seem to have a greater impact on mortality after TLR than other variables.

AB - Objectives: The aim of this study was to evaluate the prognostic impact of target lesion revascularization (TLR) of the unprotected left main coronary artery (ULMCA) after stent failure. Background: Although drug-eluting stents are safe and effective for treatment of the ULMCA, increased rates of repeat revascularization have been observed. Methods: This is a patient-level pooled analysis of the randomized ISAR-LEFT-MAIN (Drug-Eluting-Stents for Unprotected Left Main Stem Disease) and ISAR-LEFT-MAIN-2 (Drug-Eluting Stents to Treat Unprotected Coronary Left Main Disease) trials, in which patients underwent stenting of the ULMCA. The present analysis includes patients who underwent angiography during follow-up. Patients with TLR were compared with those without. Additional long-term clinical follow-up after TLR was conducted, and its influence on mortality was evaluated. Mortality was calculated using the Kaplan-Meier method. Predictors of mortality were assessed in a multivariate analysis. Results: A total of 1,001 patients were eligible, of whom 166 experienced TLR. The 5-year mortality rate was 30.2% in patients with TLR compared with 17.3% in those without TLR (p < 0.001). In the multivariate analysis, glomerular filtration rate (−30 ml/min; hazard ratio [HR]: 2.25; 95% confidence interval [CI]: 1.54 to 3.27; p < 0.001), chronic obstructive pulmonary disease (HR: 4.95; 95% CI: 1.33 to 18.42; p = 0.02), and body mass index (+5 kg/m2; HR: 1.61; 95% CI: 1.12 to 2.32; p = 0.01) were independent predictors of mortality after TLR due to left main stent failure. The type of repeat revascularization and the underlying stent did not influence the mortality after TLR of the ULMCA. Conclusions: Mortality after TLR for left main stent failure is high. Patient-related factors seem to have a greater impact on mortality after TLR than other variables.

KW - coronary artery disease

KW - in-stent restenosis

KW - repeat revascularization

KW - stent failure

KW - unprotected left main stenosis

UR - http://www.scopus.com/inward/record.url?scp=85091656759&partnerID=8YFLogxK

U2 - 10.1016/j.jcin.2020.07.017

DO - 10.1016/j.jcin.2020.07.017

M3 - Article

C2 - 33032714

VL - 13

SP - 2266

EP - 2274

JO - JACC. Cardiovascular interventions

JF - JACC. Cardiovascular interventions

SN - 1936-8798

IS - 19

ER -

ID: 13462008