| Comparing Two-Stent Strategies for Bifurcation Coronary Lesions: Which Vessel Should be Stented First, the Main Vessel or the Side Branch? | |
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MedLine Citation:
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PMID: 21860553 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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This study compared two-stent strategies for treatment of bifurcation lesions by stenting order, 'main across side first (A-family)' vs 'side branch first (S-family). The study population was patients from 16 centers in Korea who underwent drug eluting stent implantation with two-stent strategy (A-family:109, S-family:140 patients). The endpoints were cardiac death, myocardial infarction (MI), stent thrombosis (ST), and target lesion revascularization (TLR) during 3 years. During 440.8 person-years (median 20.2 months), there was 1 cardiac death, 4 MIs (including 2 STs), and 12 TLRs. Cumulative incidence of cardiac death, MI and ST was lower in A-family (0% in A-family vs 4.9% in S-family, P = 0.045). However, TLR rates were not different between the two groups (7.1% vs 6.2%, P = 0.682). Final kissing inflation (FKI) was a predictor of the hard-endpoint (hazard ratio 0.061; 95% CI 0.007-0.547, P = 0.013), but was not a predictor of TLR. The incidence of hard-endpoint of S-family with FKI was comparable to A-family, whereas S-family without FKI showed the poorest prognosis (1.1% vs 15.9%, retrospectively; P = 0.011). In conclusion, 'A-family' seems preferable to 'S-family' if both approaches are feasible. When two-stent strategy is used, every effort should be made to perform FKI, especially in 'S-family'. |
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Authors:
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Dong-Ho Shin; Kyung Woo Park; Bon-Kwon Koo; Il-Young Oh; Jae-Bin Seo; Hyeon-Cheol Gwon; Myung-Ho Jeong; In-Whan Seong; Seung Woon Rha; Ju-Young Yang; Seung-Jung Park; Jung Han Yoon; Kyoo-Rok Han; Jong-Sun Park; Seung-Ho Hur; Seung-Jea Tahk; Hyo-Soo Kim |
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Publication Detail:
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Type: Journal Article Date: 2011-07-27 |
Journal Detail:
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Title: Journal of Korean medical science Volume: 26 ISSN: 1598-6357 ISO Abbreviation: J. Korean Med. Sci. Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-08-23 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8703518 Medline TA: J Korean Med Sci Country: Korea (South) |
Other Details:
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Languages: eng Pagination: 1031-40 Citation Subset: IM |
Affiliation:
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Department of Internal Medicine, Cardiovascular Center, Seoul National University Hospital, Seoul, Korea. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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