Background: Patients with unprotected left main coronary artery disease (ULMCA) have a high mortality risk. Coronary artery bypass graft (CABG) had been the standard treatment for several decades. However, percutaneous coronary intervention (PCI) with drug-eluting stents (DES) is increasingly used as an alternative treatment.

Objective: To evaluate the safety and efficacy of second-generation drug-eluting stents in patients with ULMCA.

Materials and Methods: One hundred eighty-nine consecutive patients with ULMCA underwent PCI with second generation biolimus-eluting stents in three centers in the northeast region of Thailand. The primary end point was major adverse cardiac or cerebrovascular events (MACCE), which is a composite of all causes of mortality, myocardial infarction (MI), target vessel revascularization, and stroke.

Results: In a median follow-up of 43.0±3.6 months, MACCE occurred in 24.3% (46/189) of patients. In all causes of death, which occurred in 16.9% (32/189) of patients, there were 5.8% (11/189) of cardiac deaths and 11.1% (21/189) of non-cardiac deaths. There were 2.1% (4/189) MI and 7.4% (14/189) target vessel revascularization. No stroke occurred in the present study. Definite stent thrombosis occurred in three patients (1.6%).

Conclusion: PCI with second generation biolimus-eluting stents is considered acceptable as an alternative treatment in its safety and efficacy in patients with ULMCA.

Keywords: Unprotected left main coronary artery disease (ULMCA), Percutaneous coronary intervention (PCI), Drug eluting stent (DES)

Received 8 Aug 2018 | Revised 19 Nov 2018 | Accepted 3 Dec 2018