BACKGROUND: PCI in CBL is common and technically demanding. Whether such patients have adverse outcome during the follow-up after successful PCI is unclear. We aim to compare the clinical outcome after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation of coronary bifurcation lesions (CBL) and non-CBL. METHODS: We performed a systematic literature search to identify studies reporting the clinical outcome of patients undergoing PCI in CBL or not. Patients with left main disease constituted a predefined subgroup. Primary study end-point was major adverse cardiac events (MACE). RESULTS: Fifteen publications on 23 891 patients with coronary artery disease treated by DES in CBL or not were identified. Median follow-up length was 24 months (range: 12-60). MACE at the longest available follow-up were significantly higher in CBL as compared with non-CBL (19.0 vs. 12.1%, P < 0.001). Similar results were obtained in the subanalysis restricted to second-generation DES studies. The MACE rate was higher early, then decreased during the follow-up being, however, appreciable at all timings up to 36 months. In the left main (LM) subanalysis (four studies, 3210 patients), patients underwent DES implantation in distal LM, as compared with nondistal LM, had increased the MACE rate during the follow-up (27.4 vs. 17.4%, P < 0.001), which was driven by higher target vessel revascularization. CONCLUSIONS: In the contemporary DES era, CBL represent a subset of lesions associated with increased rate of MACE after PCI. This data prompt for studies aimed at improving the clinical outcomes of patients with CAD.
BACKGROUND: PCI in CBL is common and technically demanding. Whether such patients have adverse outcome during the follow-up after successful PCI is unclear. We aim to compare the clinical outcome after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) implantation of coronary bifurcation lesions (CBL) and non-CBL. METHODS: We performed a systematic literature search to identify studies reporting the clinical outcome of patients undergoing PCI in CBL or not. Patients with left main disease constituted a predefined subgroup. Primary study end-point was major adverse cardiac events (MACE). RESULTS: Fifteen publications on 23 891 patients with coronary artery disease treated by DES in CBL or not were identified. Median follow-up length was 24 months (range: 12-60). MACE at the longest available follow-up were significantly higher in CBL as compared with non-CBL (19.0 vs. 12.1%, P < 0.001). Similar results were obtained in the subanalysis restricted to second-generation DES studies. The MACE rate was higher early, then decreased during the follow-up being, however, appreciable at all timings up to 36 months. In the left main (LM) subanalysis (four studies, 3210 patients), patients underwent DES implantation in distal LM, as compared with nondistal LM, had increased the MACE rate during the follow-up (27.4 vs. 17.4%, P < 0.001), which was driven by higher target vessel revascularization. CONCLUSIONS: In the contemporary DES era, CBL represent a subset of lesions associated with increased rate of MACE after PCI. This data prompt for studies aimed at improving the clinical outcomes of patients with CAD.
Authors: Hendrik Wienemann; Felix Meincke; Marius Vach; Christian-Hendrik Heeger; Annika Meyer; Tobias Spangenberg; Karl Heinz Kuck; Alexander Ghanem Journal: Herz Date: 2022-04-09 Impact factor: 1.443
Authors: Jacopo Burrello; Guglielmo Gallone; Alessio Burrello; Daniele Jahier Pagliari; Eline H Ploumen; Mario Iannaccone; Leonardo De Luca; Paolo Zocca; Giuseppe Patti; Enrico Cerrato; Wojciech Wojakowski; Giuseppe Venuti; Ovidio De Filippo; Alessio Mattesini; Nicola Ryan; Gérard Helft; Saverio Muscoli; Jing Kan; Imad Sheiban; Radoslaw Parma; Daniela Trabattoni; Massimo Giammaria; Alessandra Truffa; Francesco Piroli; Yoichi Imori; Bernardo Cortese; Pierluigi Omedè; Federico Conrotto; Shao-Liang Chen; Javier Escaned; Rosaly A Buiten; Clemens Von Birgelen; Paolo Mulatero; Gaetano Maria De Ferrari; Silvia Monticone; Fabrizio D'Ascenzo Journal: J Pers Med Date: 2022-06-17
Authors: Thomas F Valenzuela; Francesco Burzotta; Tinen L Iles; Jens F Lassen; Paul A Iaizzo Journal: Int J Cardiovasc Imaging Date: 2021-05-16 Impact factor: 2.357