Document Detail


Stenting strategy for coronary artery bifurcation with drug-eluting stents: a meta-analysis of 9 randomised trials and systematic review.
MedLine Citation:
PMID:  24970736     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Aims: The present study sought to compare angiographic and clinical outcomes of simple strategy versus complex strategy in patients with coronary bifurcation lesions undergoing drug-eluting stent implantation. Methods and results: Medline, the Cochrane Library, and other internet sources were searched for randomised trials comparing simple strategy versus complex strategy for treating patients with bifurcation lesions. Nine eligible randomised trials including 2,569 patients were identified. Meta-analysis showed that cardiac death (odds ratio [OR]: 0.99, 95% confidence interval [CI]: 0.40-2.41, p=0.98) and stent thrombosis (OR: 0.64, 95% CI: 0.31-1.34, p=0.24) were similar in the simple and the complex strategy. Compared with the complex strategy, the simple strategy was associated with a reduced risk of either early or follow-up myocardial infarction (OR: 0.53, 95% CI: 0.36-0.79, p=0.002; OR: 0.60, 95% CI: 0.43-0.86, p=0.01, respectively). The overall risks of side branch restenosis (OR: 1.44, 95% CI: 0.73-2.87, p=0.30), target lesion (OR: 1.72, 95% CI: 0.95-3.12, p=0.07) and target vessel revascularisation (OR: 1.59, 95% CI: 0.94-2.69, p=0.09) were comparable between the two groups. In the true bifurcation, large side branch, and DK-crush subgroups, there were higher rates of reintervention seen in the simple strategy than in the complex strategy. Conclusions: Complex strategy remains an optional treatment for patients with coronary bifurcation lesions without severe safety concerns. Complex strategy may be an optimal treatment for true bifurcation lesions together with large side branches.
Authors:
Xiao-Fei Gao; Yao-Jun Zhang; Nai-Liang Tian; Wen Wu; Ming-Hui Li; Christos V Bourantas; Xiao-Min Jiang; Zhi-Mei Wang; Bing Li; Wen-Xing Mao; Jun-Jie Zhang; Shao-Liang Chen
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-28
Journal Detail:
Title:  EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology     Volume:  -     ISSN:  1969-6213     ISO Abbreviation:  EuroIntervention     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-6-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101251040     Medline TA:  EuroIntervention     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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