Clinical outcomes of transradial unprotected left main coronary artery stenting in the elderly

OBJECTIVES: To evaluate the long-term results in elderly patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents for unprotected left main coronary artery disease by transradial approach.

METHODS: This study took place in Qinhuangdao First Hospital, Hebei Medical University, Hebei, China between October 2006 and December 2009. Seventy-nine elderly patients with unprotected left main coronary artery (ULMCA) stenosis, aged >70 years, that underwent drug-eluting stent were evaluated. The occurrence of major adverse cardiac events (MACE) (death, non-fatal myocardial infarction, stroke or target lesion revascularizations) was recorded after 3 years of follow-up.

RESULTS: After 3 years follow-up, the MACE free survival rate was 72.2%. Cardiac deaths occured in 7.6% of patients. Myocardial infarction occurred in 5.1%, and target lesion revascularization in 13.9% of patients. Age and left main distal bifurcation were favorable predictors of MACE. Conclusions: Percutaneous coronary intervention can be performed with good angiographic and clinical results through a transradial approach in the elderly. The long term survival suggests that PCI in ULMCA patients ≥70 years is safe and efficacious.