Title Crush Stenting With Drug-Eluting Stents: Relevance of Coronary Bifurcation Lesion Location on Angiographic and Clinical Outcomes
Authors Chen, Shao-Liang
Zhang, Jun-jie
Ye, Fei
Liu, Zhi-zhong
Zhu, Zhong-sheng
Lin, Song
Tian, Nai-liang
Fang, Wei-yi
Chen, Yun-dai
Sun, Xue-wen
Wei, Meng
Shan, Shou-jie
Kan, Jing
Qian, Jun
Yang, Song
Yuan, Zeng-bai
Kwan, Tak W.
Hu, Da-Yi
Affiliation Nanjing Med Univ, Nanjing Hosp 1, Nanjing, Peoples R China.
Shanghai Chest Hosp, Shanghai, Peoples R China.
Capital Med Univ, Beijing Anzhen Hosp, Beijing, Peoples R China.
Huainan Dongfang Hosp, Huainan, Peoples R China.
Shanghai 6th Hosp, Shanghai, Peoples R China.
Maanshan Cent Hosp, Maanshan, Peoples R China.
Yixin Peoples Hosp, Yixin, Peoples R China.
Huaibei Mineral Gen Hosp, Huaibei, Peoples R China.
Peking Univ, Peoples Hosp, Beijing 100871, Peoples R China.
Nanjing Med Univ, Nanjing Hosp 1, 68 Changle Rd, Nanjing, Peoples R China.
Keywords ARTERY BIFURCATION
FOLLOW-UP
REVASCULARIZATION
REGISTRY
ERA
PREDICTORS
IMMEDIATE
STENOSIS
INSIGHTS
BRANCH
Issue Date 2010
Publisher clinical cardiology
Citation CLINICAL CARDIOLOGY.2010,33,(12),E32-E39.
Abstract Background: Data on the relevance of the location of coronary bifurcation lesions treated by crush stenting with outcomes were limited. Hypothesis: We hypothesized that the location of the bifurcation lesion correlated with clinical outcome. Method: A total of 212 patients with 230 true bifurcation lesions treated by crush stenting with drug-eluting stents (DES) were assessed prospectively. Surveillance quantitative angiographies were indexed at 8 months after procedure. Primary endpoint was major adverse cardiac events (MACE), defined as cardiac death, myocardial infarction, and target lesion revascularization (TLR). Results: Patients in the distal right coronary artery (RCAd) group were characterized by higher proportions of prior myocardial infarction and very tortuous lesions. However, lesions in the RCAd group, compared to those of other groups, had the lowest late lumen loss, with resultant lowest incidence of MACE at a mean follow-up of 268 +/- 35 days. Independent predictors of MACE included unsatisfied kissing (KUS; hazard ratio [HR]: 12.14, 95% confidence interval [CI]: 4.01-12.10, P = .001) and non-RCA lesion (HR: 20.69, 95% CI: 5.05-22.38, P = .001), while those of TLR were KUS (HR: 10.21, 95% CI: 0.01-0.34, P = .002), bifurcation angle (HR: 4.728, 95% CI: 2.541-4.109, P = .001), and non-RCA lesion (HR: 16.05, 95% CI: 1.01-4.83, P = .001). Conclusions: Classical crush stenting with drug-eluting stents is associated with significantly better outcomes in RCAd. Quality of kissing inflation is mandatory to improve outcome.
URI http://hdl.handle.net/20.500.11897/242016
ISSN 0160-9289
DOI 10.1002/clc.20544
Indexed SCI(E)
Appears in Collections: 人民医院

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