001 SIROLIMUS ELUTING STENT AND UNPROTECTED LEFT MAIN STENOSIS: THE MULTICENTER E-CYPHER REGISTRY

A. Gershlick, G. Guagliumi, P. Guyon, C. Lotan, J. Schofer, P. Urban, W. Wijns.University Hospitals of Leicester and Others

Background: While treatment of unprotected left main stem (LMS) lesion with PCI remains somewhat controversial, improved outcome through reduced recurrence rates may influence opinion away from the surgical towards the percutaneous approach. The use of sirolimus eluting stents (SES) in LMS, although intuitive, requires careful assessment in real world cases.

Methods: Since April 2002, 220 patients with unprotected LMCA lesions from 79 international centres were prospectively entered in the e-CYPHER database, an ongoing, prospective post marketing, internet based registry. Patient follow up was obtained at 1, 6, and 12 months by patient visit and/or phone contact.

Results: Six month follow up to time of abstract submission is available for 173 patients, with mean age of 66 (SD 11) years. There were 22% diabetics, 28% with prior myocardial infarction (MI), 43% had prior PCI, and 38% prior coronary artery bypass graft (CABG). Main indications for PCI were stable angina (42%), unstable angina (42%), silent ischaemia (8%), and recent or acute MI (4%). Fifty four per cent of patients had three coronary vessels disease. The mean LMS lesion length was 13.1 (SD 7.1) mm and the mean reference coronary vessel diameter was 3.1 (SD 0.4) mm. Overall 1.01 (SD 0.28) SES/LMS lesion were implanted in native (83%) or restenotic lesion (17%). Direct stenting was used in 33%. The combined in-hospital major adverse cardiac events (MACE) rate was 0% with no target vessel failure. At the present time, 6 month follow up has been collected in 163 patients (73%). Incidence of any MACE was reported in 3.7% of cases with 1.8% death, 0.6% MI, and 1.8% target lesion revascularization. Complete 6 month clinical follow up will be available for the presentation.

Conclusion: In …