Coronary disease & ACSMeta-analysis
Impact of Target Lesion Revascularization on Long-Term Mortality After Percutaneous Coronary Intervention for Left Main Disease
- Pooled analysis of 4 multicentre observational registries
- time-varying multivariable Cox model
Authors' conclusion
Although the incidence of ischemia-driven TLR was mostly common within 2 years after left main PCI, TLR occurred steadily during the 10-year follow-up period. However, given that such patients were optimally revascularized, the prognostic impact of TLR on mortality was not substantial.
Study context
- Population
- Patients with unprotected left main coronary artery (LMCA) disease treated with drug-eluting stents (DES) and available long-term mortality data
- Participants
- 1,397 patients · 4 registries
- Comparison
- Target lesion revascularization (TLR) vs no TLR after left main percutaneous coronary intervention (PCI) with DES
- TLRn = 118
- Outcome
- Association of TLR with all-cause mortality
- Follow-up
- 10 years
Pooled result
Mortality
Adjusted hazard ratio
0.90
95% CI 0.50–1.63
P = 0.73
TLR vs No TLR
adjusted HR 0.90 (95% CI 0.50–1.63); P = 0.73
As reported in the abstract
Further pooled results
TLR incidence · 10 years
- TLR occurred (patients)
- 118
- 10-year cumulative incidence of TLR
- 10.8%
- Early-stage TLR (within 2 years)
- 73 (61.9%)
- Late-stage TLR (beyond 2 years)
- 45 (38.1%)
- TLR by CABG
- 23
- TLR by repeat PCI
- 95
- median follow-up 6.8 years
Original publication
Impact of Target Lesion Revascularization on Long-Term Mortality After Percutaneous Coronary Intervention for Left Main Disease. JACC Cardiovasc Interv. Published 8 January 2024. doi:10.1016/j.jcin.2023.10.068
Summarised from the published abstract; every number is checked against it