Mid term outcomes after percutaneous interventions in coronary bifurcations
Int. j. cardiol
; 15(283): 78-83, Maio 2019. tabela, gráfico
Article
em En
| SES-SP, SESSP-IDPCPROD, SES-SP
| ID: biblio-1023866
Biblioteca responsável:
BR79.1
Localização: BR79.1
ABSTRACT
BACKGROUND:
The optimal treatment of patients undergoing percutaneous coronary interventions (PCI) for lesions located at coronary bifurcations is still debated.METHODS:
Data on 5036 consecutive patients who underwent PCI on coronary bifurcation at 17 major coronary intervention centers between January 2012 and December 2014 were collected.RESULTS:
Follow-up at a median 18â¯months (IQR 11-28) was available for 4506 patients (89%). Major Adverse Cardiac Events (MACE) occurred in 395 patients (8.8%) cardiac death in 152 (3.4%), myocardial infarction, excluding periprocedural, in 156 (3.5%) and stent thrombosis in 110 cases (2.4%). At multivariable Cox regression, left ventricular ejection fraction ≤30% (Pâ¯<â¯0.001), bail-out stenting (beyond a planned strategy of either single or double stenting) (Pâ¯<â¯0.001), admission for an acute coronary syndrome (Pâ¯<â¯0.001), age >66â¯years (Pâ¯<â¯0.001), multivessel disease (Pâ¯<â¯0.001) and diabetes (Pâ¯<â¯0.001) were independently associated with MACE. Sensitivity analysis identified premature discontinuation of dual antiplatelet therapy (DAPT) (Pâ¯<â¯0.001) and side branch (SB) lesion length ≥9â¯mm (Pâ¯<â¯0.05) as additional independent predictors of MACE.CONCLUSIONS:
Beyond traditional risk factors, multivessel disease, the length of the SB lesion, "bail-out" stenting and premature DAPT discontinuation are independent predictors of mid-term MACE after PCI of coronary bifurcations. This highlights the importance of a carefully planned PCI strategy and adequate therapy adherence to improve the clinical outcomes in these patients. (AU)
Texto completo:
1
Base de dados:
SES-SP
/
SESSP-IDPCPROD
Assunto principal:
Stents Farmacológicos
/
Intervenção Coronária Percutânea
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article