Title |
Long-Term Clinical Outcomes and Optimal Stent Strategy in Left Main Coronary Bifurcation Stenting
|
---|---|
Published in |
JACC: Cardiovascular Interventions, July 2018
|
DOI | 10.1016/j.jcin.2018.03.009 |
Pubmed ID | |
Authors |
Sungsoo Cho, Tae Soo Kang, Jung-Sun Kim, Sung-Jin Hong, Dong-Ho Shin, Chul-Min Ahn, Byeong-Keuk Kim, Young-Guk Ko, Donghoon Choi, Young Bin Song, Joo-Yong Hahn, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Myeong-Ki Hong, Yansoo Jang |
Abstract |
This study sought to investigate the long-term clinical effects of stent generation and stent strategy for left main coronary artery (LMCA) bifurcation lesion treatment. Limited data are available to assess long-term clinical outcomes after stenting, including use of current-generation drug-eluting stent (C-DES) for treatment of LMCA bifurcation lesions. A total of 1,353 patients who were recorded in 2 multicenter real-world registries were treated by either early-generation drug-eluting stent (E-DES) (n = 889) or C-DES (n = 464). Primary endpoint was major adverse cardiovascular events (MACE). MACE was defined as a composite of cardiac death or myocardial infarction, stent thrombosis, and target lesion revascularization rates during 3-year follow-up. The authors further performed propensity-score adjustment for clinical outcomes. During 3-year follow-up, the overall MACE rate was 8.7%. Use of a 1-stent strategy resulted in better clinical outcomes than use of a 2-stent strategy (4.7% vs. 18.6%, hazard ratio [HR]: 3.71; 95% confidence interval [CI]: 2.55 to 5.39; p < 0.001). Use of C-DES resulted in a lower MACE rate compared with using E-DES (4.6% vs. 10.9%, HR: 0.55; 95% CI: 0.34 to 0.89; p = 0.014), especially for the 2-stent strategy. For patients with C-DES, the presence of chronic kidney disease and pre-intervention side branch diameter stenosis ≥50% were significant independent predictors of MACE. Intervention of LMCA bifurcation lesions using DES implantation demonstrated acceptable long-term clinical outcomes, especially in C-DES patients. Use of a 1-stent strategy resulted in better clinical benefits than using a 2-stent strategy. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
United States | 11 | 21% |
United Kingdom | 6 | 11% |
Spain | 5 | 9% |
Colombia | 3 | 6% |
Mexico | 3 | 6% |
Venezuela, Bolivarian Republic of | 3 | 6% |
Malaysia | 1 | 2% |
El Salvador | 1 | 2% |
Belgium | 1 | 2% |
Other | 6 | 11% |
Unknown | 13 | 25% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 30 | 57% |
Scientists | 12 | 23% |
Practitioners (doctors, other healthcare professionals) | 9 | 17% |
Science communicators (journalists, bloggers, editors) | 2 | 4% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Unknown | 42 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 8 | 19% |
Student > Doctoral Student | 4 | 10% |
Other | 4 | 10% |
Student > Postgraduate | 4 | 10% |
Student > Bachelor | 3 | 7% |
Other | 4 | 10% |
Unknown | 15 | 36% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 21 | 50% |
Social Sciences | 2 | 5% |
Agricultural and Biological Sciences | 1 | 2% |
Chemical Engineering | 1 | 2% |
Engineering | 1 | 2% |
Other | 0 | 0% |
Unknown | 16 | 38% |