Coronary artery disease · 2019
Temporal changes in characteristics, treatment strategies, and outcomes of coronary bifurcation lesion interventions.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Kang Se Hun, Ahn Jung-Min, Lee Jung-Bok, Lee Cheol Hyun, Kang Do-Yoon, Lee Pil Hyung, Kang Soo-Jin, Lee Seung-Whan, Kim Young-Hak, Lee Cheol Whan, Park Seong-Wook, Park Duk-Woo, Park Seung-Jung
Аннотация
OBJECTIVES: Coronary bifurcations are common in daily practice of percutaneous coronary intervention and remain one of the most challenging lesions, but it is still unknown how characteristics, treatment strategy, and outcomes have changed over the last decade of drug-eluting stents (DES) era. We evaluated characteristics of treatment pattern and outcomes for patients with bifurcation disease over time in real-world clinical practice.
PATIENTS AND METHODS: A total of 7282 patients with coronary bifurcation lesions were pooled from the Interventional Cardiology Research Incorporation Society-Drug-Eluting Stents registry and the Interventional Research Incorporation Society-Left MAIN registry. Primary outcome was a target-vessel failure (TVF), defined as a composite of cardiac death, target-vessel myocardial infarction, or clinically indicated target-vessel revascularization.
RESULTS: Among the total population, 2232 (30.7%) had left main bifurcation lesions. The use of one-stent strategy was more frequent in conjunction with second-generation DES (86.2 vs. 13.8%) than with first-generation DES (65.4 vs. 34.6%). Two-stent strategy was associated with a higher risk of TVF as compared with one-stent strategy [adjusted hazard ratio (HR): 1.28, 95% confidence interval (CI): 1.12-1.47, P<0.001]. However, the risk of TVF with two-stent strategy relative to one-stent strategy has decreased from the first-generation DES (HR: 1.56, 95% CI: 1.22-1.99, P<0.001) to the second-generation DES (HR: 1.12, 95% CI: 0.94-1.34, P=0.19).
CONCLUSION: For patients with bifurcation disease, stenting strategy has become more simpler and percutaneous coronary intervention outcomes have more improved over time. One-stent strategy relative to two-stent strategy was associated with better clinical outcomes, but the advantage of one-stent strategy was less pronounced with the use of second-generation DES.
PATIENTS AND METHODS: A total of 7282 patients with coronary bifurcation lesions were pooled from the Interventional Cardiology Research Incorporation Society-Drug-Eluting Stents registry and the Interventional Research Incorporation Society-Left MAIN registry. Primary outcome was a target-vessel failure (TVF), defined as a composite of cardiac death, target-vessel myocardial infarction, or clinically indicated target-vessel revascularization.
RESULTS: Among the total population, 2232 (30.7%) had left main bifurcation lesions. The use of one-stent strategy was more frequent in conjunction with second-generation DES (86.2 vs. 13.8%) than with first-generation DES (65.4 vs. 34.6%). Two-stent strategy was associated with a higher risk of TVF as compared with one-stent strategy [adjusted hazard ratio (HR): 1.28, 95% confidence interval (CI): 1.12-1.47, P<0.001]. However, the risk of TVF with two-stent strategy relative to one-stent strategy has decreased from the first-generation DES (HR: 1.56, 95% CI: 1.22-1.99, P<0.001) to the second-generation DES (HR: 1.12, 95% CI: 0.94-1.34, P=0.19).
CONCLUSION: For patients with bifurcation disease, stenting strategy has become more simpler and percutaneous coronary intervention outcomes have more improved over time. One-stent strategy relative to two-stent strategy was associated with better clinical outcomes, but the advantage of one-stent strategy was less pronounced with the use of second-generation DES.