METHODS: Patients undergoing PCI to left anterior descending (LAD) bifurcation lesions with contemporary DES were analyzed from a nationwide registry. Baseline risk was assessed using the Age, Creatinine, and Ejection Fraction (ACEF) score. Target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization, was assessed at 3 years. RESULTS: Among 1,089 patients with LAD bifurcation lesions, 548 (50.3%) patients underwent SB treatment. The SB treatment group showed a nonsignificant, but numerically lower rate of 3-year TLF (6.6% vs. 9.2%, HR 0.75, 95%CI 0.44-1.28, p = 0.29). In patients with low pretreatment risk (ACEF<1.22), SB treatment was associated with a lower rate of 3-year TLF (HR 0.43, 95%CI 0.19-0.96, p = 0.04), while no significant difference was observed in patients with high risk (ACEF≥1.22). The difference in the low risk group was mostly driven by target lesion revascularization (HR 0.24, 95%CI 0.08-0.75, p = 0.01). CONCLUSIONS: SB treatment for LAD bifurcation lesions showed favorable long-term outcomes compared with main-branch-only intervention, especially in patients with low pretreatment risk.
METHODS: Patients undergoing PCI to left anterior descending (LAD) bifurcation lesions with contemporary DES were analyzed from a nationwide registry. Baseline risk was assessed using the Age, Creatinine, and Ejection Fraction (ACEF) score. Target lesion failure (TLF), a composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization, was assessed at 3 years. RESULTS: Among 1,089 patients with LAD bifurcation lesions, 548 (50.3%) patients underwent SB treatment. The SB treatment group showed a nonsignificant, but numerically lower rate of 3-year TLF (6.6% vs. 9.2%, HR 0.75, 95%CI 0.44-1.28, p = 0.29). In patients with low pretreatment risk (ACEF<1.22), SB treatment was associated with a lower rate of 3-year TLF (HR 0.43, 95%CI 0.19-0.96, p = 0.04), while no significant difference was observed in patients with high risk (ACEF≥1.22). The difference in the low risk group was mostly driven by target lesion revascularization (HR 0.24, 95%CI 0.08-0.75, p = 0.01). CONCLUSIONS: SB treatment for LAD bifurcation lesions showed favorable long-term outcomes compared with main-branch-only intervention, especially in patients with low pretreatment risk.
Authors: Joanna J Wykrzykowska; Scot Garg; Yoshinobu Onuma; Ton de Vries; Dick Goedhart; Marie-Angele Morel; Gerrit-Anne van Es; Pawel Buszman; Axel Linke; Thomas Ischinger; Volker Klauss; Roberto Corti; Franz Eberli; William Wijns; Marie-Claude Morice; Carlo di Mario; Robert Jan van Geuns; Peter Juni; Stephan Windecker; Patrick W Serruys Journal: Circ Cardiovasc Interv Date: 2011-01-04 Impact factor: 6.546
Authors: Hector M Garcia-Garcia; Eugène P McFadden; Andrew Farb; Roxana Mehran; Gregg W Stone; John Spertus; Yoshinobu Onuma; Marie-Angèle Morel; Gerrit-Anne van Es; Bram Zuckerman; William F Fearon; David Taggart; Arie-Pieter Kappetein; Mitchell W Krucoff; Pascal Vranckx; Stephan Windecker; Donald Cutlip; Patrick W Serruys Journal: Eur Heart J Date: 2018-06-14 Impact factor: 29.983