Long-Term Results After Simple Versus Complex Stenting of Coronary Artery Bifurcation Lesions Nordic Bifurcation Study 5-Year Follow-Up Results

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:62

Article

Maeng, Michael¹  Holm, Niels R.¹  Erglis, Andrejs²  Kumsars, Indulis²  Niemela, Matti³  Kervinen, Kari³  Jensen, Jan S.⁴  Galloe, Anders⁴  Steigen, Terje K.^5,6  Wiseth, Rune⁸  Narbute, Inga²  Gunnes, Pal⁹  Mannsverk, Jan⁷  Meyerdierks, Oliver¹⁰  Rotevatn, Svein¹¹  Nikus, Kjell¹²  Vikman, Saila¹²  Ravkilde, Jan¹³  James, Stefan¹⁴  Aaroe, Jens¹³  Ylitalo, Antti¹⁵  Helqvist, Steffen¹⁶  Sjogren, Iwar¹⁷  Thayssen, Per¹⁸  Virtanen, Kari¹⁹  Puhakka, Mikko²⁰  Airaksinen, Juhani²¹  Christiansen, Evald H.¹  Lassen, Jens F.¹  Thuesen, Leif¹ 

[1] Aarhus Univ Hosp, Dept Cardiol, Skejby, Denmark

[2] Paul Stradins Clin Hosp, Dept Cardiol, Riga, Latvia

[3] Oulu Univ Hosp, Div Cardiol, Oulu, Finland

[4] Gentofte Univ Hosp, Dept Cardiol, Gentofte, Denmark

[5] Univ Tromso, Univ Hosp North Norway, Dept Cardiol, Tromso, Norway

[6] Univ Tromso, Inst Clin Med, Tromso, Norway

[7] Univ Tromso Hosp, Dept Cardiol, N-9012 Tromso, Norway

[8] St Olav Hosp, Dept Cardiol, Trondheim, Norway

[9] Feiring Clin, Dept Cardiol, Feiring, Norway

[10] Ullevaal Univ Hosp, Dept Cardiol, Oslo, Norway

[11] Haukeland Hosp, Dept Cardiol, N-5021 Bergen, Norway

[12] Tampere Univ Hosp, Dept Cardiol, Tampere, Finland

[13] Aalborg Univ Hosp, Dept Cardiol, Aalborg, Denmark

[14] Univ Uppsala Hosp, Dept Cardiol, Uppsala, Sweden

[15] Satakunta Cent Hosp, Dept Cardiol, Pori, Finland

[16] Rigshosp, Dept Cardiol, DK-2100 Copenhagen, Denmark

[17] Falun Cent Hosp, Dept Cardiol, Falun, Sweden

[18] Odense Univ Hosp, Dept Cardiol, DK-5000 Odense, Denmark

[19] Univ Helsinki, Cent Hosp, Div Cardiol, Helsinki, Finland

[20] Univ Kuopio, Cent Hosp, Div Cardiol, Kuopio, Finland

[21] Turku Univ, Cent Hosp, Div Cardiol, Turku, Finland

关键词: bifurcation;    drug-eluting stent;    randomized;    restenosis;    stent thrombosis;   

DOI  :  10.1016/j.jacc.2013.04.015

来源: Elsevier

【 摘 要 】

Objectives This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study. Background Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy. Methods A total of 413 patients with a coronary bifurcation lesion were randomly assigned to a simple stenting strategy of main vessel (MV) and optional stenting of side branch (SB) or to a complex stenting strategy, namely, stenting of both MV and SB. Results Five-year clinical follow-up data were available for 404 (98%) patients. The combined safety and efficacy endpoint of cardiac death, non-procedure-related myocardial infarction, and target vessel revascularization were seen in 15.8% in the optional SB stenting group as compared to 21.8% in the MV and SB stenting group (p = 0.15). All-cause death was seen in 5.9% versus 10.4% (p = 0.16) and non-procedure-related myocardial infarction in 4% versus 7.9% (p = 0.09) in the optional SB stenting group versus the MV and SB stenting group, respectively. The rates of target vessel revascularization were 13.4% versus 18.3% (p = 0.14) and the rates of definite stent thrombosis were 3% versus 1.5% (p = 0.31) in the optional SB stenting group versus the MV and SB stenting group, respectively. Conclusions At 5-year follow-up in the Nordic Bifurcation Study, the clinical outcomes after simple optional side branch stenting remained at least equal to the more complex strategy of planned stenting of both the main vessel and the side branch. (C) 2013 by the American College of Cardiology Foundation

【 授权许可】

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