TY - JOUR
T1 - Coronary bifurcation lesions treated with simple or complex stenting
T2 - 5-year survival from patient-level pooled analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study
AU - Behan, Miles W
AU - Holm, Niels R
AU - de Belder, Adam J
AU - Cockburn, James
AU - Erglis, Andrejs
AU - Curzen, Nicholas P
AU - Niemelä, Matti
AU - Oldroyd, Keith G
AU - Kervinen, Kari
AU - Maeng, Michael
AU - Ravkilde, Jan
AU - Jensen, Jan Skov
AU - Christiansen, Evald H
AU - Cooter, Nina
AU - Steigen, Terje K
AU - Vikman, Saila
AU - Thuesen, Leif
AU - Lassen, Jens Flensted
AU - Hildick-Smith, David
N1 - Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: [email protected].
PY - 2016/6/21
Y1 - 2016/6/21
N2 - AIMS: Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study: old, new, and evolving strategies (BBC ONE).METHODS AND RESULTS: Both multicentre randomized trials compared simple (provisional T-stenting) vs. complex (culotte, crush, and T-stenting) techniques, using drug-eluting stents. We analysed all-cause death at 5 years. Data were collected from phone follow-up, hospital records, and national mortality tracking. Follow-up was complete for 890 out of 913 patients (97%). Both Simple and Complex groups were similar in terms of patient and lesion characteristics. Five-year mortality was lower among patients who underwent a simple strategy rather than a complex strategy [17 patients (3.8%) vs. 31 patients (7.0%); P = 0.04].CONCLUSION: For coronary bifurcation lesions, a provisional single-stent approach appears to be associated with lower long-term mortality than a systematic dual stenting technique.
AB - AIMS: Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study: old, new, and evolving strategies (BBC ONE).METHODS AND RESULTS: Both multicentre randomized trials compared simple (provisional T-stenting) vs. complex (culotte, crush, and T-stenting) techniques, using drug-eluting stents. We analysed all-cause death at 5 years. Data were collected from phone follow-up, hospital records, and national mortality tracking. Follow-up was complete for 890 out of 913 patients (97%). Both Simple and Complex groups were similar in terms of patient and lesion characteristics. Five-year mortality was lower among patients who underwent a simple strategy rather than a complex strategy [17 patients (3.8%) vs. 31 patients (7.0%); P = 0.04].CONCLUSION: For coronary bifurcation lesions, a provisional single-stent approach appears to be associated with lower long-term mortality than a systematic dual stenting technique.
KW - Journal Article
U2 - 10.1093/eurheartj/ehw170
DO - 10.1093/eurheartj/ehw170
M3 - Journal article
C2 - 27161619
SN - 1522-9645
VL - 37
SP - 1923
EP - 1928
JO - European Heart Journal (Online)
JF - European Heart Journal (Online)
IS - 24
ER -