Comparison of the planned one- and elective two-stent techniques in patients with coronary bifurcation lesions with or without acute coronary syndrome from the COBIS II Registry.

Autor: Kim MC; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwnagju, Republic of Korea., Ahn Y; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwnagju, Republic of Korea., Sun Sim D; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwnagju, Republic of Korea., Joon Hong Y; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwnagju, Republic of Korea., Han Kim J; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwnagju, Republic of Korea., Ho Jeong M; Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital, Gwnagju, Republic of Korea., Gwon HC; Division of Cardiology, Department of Internal Medicine, Samsung Medical Center, Seoul, Republic of Korea., Kim HS; Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea., Rha SW; Division of Cardiology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Republic of Korea., Yoon JH; Division of Cardiology, Department of Internal Medicine, Wonju Christian Hospital, Wonju, Republic of Korea., Jang Y; Division of Cardiology, Department of Internal Medicine, Yonsei University Severance Hospital, Seoul, Republic of Korea., Tahk SJ; Division of Cardiology, Department of Internal Medicine, Ajou University Hospital, Suwon, Republic of Korea., Seung KB; Division of Cardiology, Department of Internal Medicine, Catholic University Kangnam, St. Mary's Hospital, Seoul, Republic of Korea.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2018 Nov 15; Vol. 92 (6), pp. 1050-1060. Date of Electronic Publication: 2018 Mar 24.
DOI: 10.1002/ccd.27551
Abstrakt: Objectives: To evaluate the impacts of stent techniques on long-term clinical outcomes after percutaneous coronary intervention (PCI) using drug-eluting stents (DES) for coronary bifurcation lesions in patients with or without acute coronary syndrome (ACS).
Background: Few studies have investigated the impacts of stent techniques for treating coronary bifurcation lesions in patients with and without ACS.
Methods: This multicenter registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions. We investigated the impacts of planned one-stent and elective two-stent techniques in patients with (n = 1,798) and those without (n = 1,099) ACS. Primary endpoint was the incidence of 3-year target-lesion failure (TLF), defined as a composite of cardiac death, spontaneous myocardial infarction, and target-lesion revascularization.
Results: The planned one-stent technique reduced TLF rate compared to elective two-stent technique in the ACS cohort (hazard ratio [HR] 0.49; 95% confidence interval [CI] 0.34-0.74; P = 0.001), and not in the non-ACS cohort (HR 0.61; 95% CI 0.35-1.06; P = 0.079). After propensity score matching, the planned one-stent technique had a significantly lower TLF rate (HR 0.47; 95% CI 0.29-0.74; P = 0.001) in patients with ACS, and it also showed a trend toward lower TLF rate with the planned one-stent technique in patients without ACS (9.0 vs. 14.5%, HR 0.59; 95% CI 0.32-1.14; P = 0.116).
Conclusions: Planned one-stenting reduced TLF in patients with ACS and it also might be beneficial in those without ACS for the treatment of coronary bifurcation lesions.
(© 2018 Wiley Periodicals, Inc.)
Databáze: MEDLINE
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