Document Detail


Comparison of Provisional 1-Stent and 2-Stent Strategies in Diabetic Patients With True Bifurcation Lesions: The EES Bifurcation Study.
MedLine Citation:
PMID:  25480989     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Percutaneous coronary intervention (PCI) of true bifurcation lesions (Medina classification 1, 1, 1; 1, 0, 1; or 0, 1, 1) is challenging and may involve either a 1-stent strategy with provisional side branch stenting, or a 2-stent strategy. Diabetes mellitus is associated with greater atherosclerotic burden and higher incidence of bifurcation lesions, and unfavorable outcomes after PCI. It is unknown whether use of newer everolimus-eluting stent (EES) implantation impacts relative outcomes of 1-stent and 2-stent strategies in patients with diabetes.
METHODS: We performed a retrospective analysis of consecutive patients with diabetes mellitus and complex true bifurcation lesions (side branch diameter >2.0 mm) who underwent PCI with EES between February 2010 and December 2011. We grouped subjects based on initial treatment to a 1-stent (n = 81) or 2-stent (n = 54) strategy, and compared baseline characteristics, quantitative coronary angiography, and 1-year major adverse cardiovascular event (MACE) rates, defined as death, myocardial infarction, target lesion revascularization (TLR), or target vessel revascularization (TVR).
RESULTS: Baseline characteristics were well matched. A 2-stent strategy was associated with larger side-branch reference vessel diameter at baseline and post PCI. In-hospital events included 1 periprocedural myocardial infarction in each group and no deaths. At 1 year, there was no significant difference between 1-stent and 2-stent strategies in TVR rates (6.2% vs 3.7%; P=.53), TLR (both 3.7%; P>.99), or MACE (7.4% vs 3.7%; P=.37).
CONCLUSION: In this series of diabetic patients undergoing complex bifurcation PCI using EES implantation, there was no difference between 1-stent and 2-stent strategies with respect to ischemic events at 1 year.
Authors:
Omar A Meelu; Matthew I Tomey; Samantha Sartori; Nisharahmed Kherada; Marco G Mennuni; Kleanthis N Theodoropoulos; Swapna Sayeneni; Usman Baber; Robert T Pyo; Jason C Kovacic; Pedro Moreno; Prakash Krishnan; Roxana Mehran; George D Dangas; Annapoorna S Kini; Samin K Sharma
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Publication Detail:
Type:  JOURNAL ARTICLE    
Journal Detail:
Title:  The Journal of invasive cardiology     Volume:  26     ISSN:  1557-2501     ISO Abbreviation:  J Invasive Cardiol     Publication Date:  2014 Dec 
Date Detail:
Created Date:  2014-12-6     Completed Date:  -     Revised Date:  2014-12-7    
Medline Journal Info:
Nlm Unique ID:  8917477     Medline TA:  J Invasive Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  619-623     Citation Subset:  -    
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