Everolimus-eluting stents are largely used for left main (LM) percutaneous coronary
interventions (PCI). Long-term follow-up of patients who underwent LM PCI in a real
world clinical setting, in particular women, have been scarcely reported. Consecutive
patients who underwent unprotected LM PCI with EES at a single Institution from December
2006 to April 2016 were included. Main outcome assessed was the occurrence of major
adverse cardiovascular events (MACE) as a composite of death, myocardial infarction
or target lesion revascularization at follow-up. Overall, 589 patients (20.8% women)
were included in the present analysis. Women were older, had lower body mass index
and more frequently hypertensive compared with men. Main clinical presentation was
stable coronary artery disease (CAD); unstable angina was more frequently observed
in women compared with men, whereas ST-elevation myocardial infarction was less frequent.
After 69.7 ± 28.3 months of follow-up, 47 patients overall experienced MACE (1.43
per 100*patients/year). MACE rate was higher in women compared with male patients,
with a rate of 2.49 and 1.17 per 100*patients/year, respectively (p = 0.015). The
difference was driven mainly by higher mortality in women (0.89 vs 0.15 per 100*patients/years,
p = 0.002). At multivariable Cox regression, female gender was independently associated
with an increased risk of MACE at follow-up (hazard ratio 2.21, 95% confidence interval
1.20 to 4.08, p = 0.011). In conclusion, EES can be safely and effectively adopted
for LM PCI.
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Article info
Publication history
Published online: August 16, 2019
Received in revised form:
July 24,
2019
Received:
May 26,
2019
Identification
Copyright
© 2019 Elsevier Inc. All rights reserved.
