Long term results after percutanous coronary intervention in large cohort of coronary bifurcation lesions in large volume center in single versus double stenting

Abstract

The coronary bifurcation lesion remains a unique challenge for the modern interventionalist. Current outcome data in treatment of bifurcation lesions have shown varying results. Additionally, long-term outcomes remain largely unexplored. The main objective of this study is to investigate and compare the long-term outcome of patients after percutaneous coronary interventions in bifurcation lesions in single versus double stenting strategies in a large volume center. We analyzed 3991 patients from a large registry undergoing percutaneous coronary interventions for bifurcation lesions for over 3 years. Primary endpoint was major adverse cardiac events (MACE) consisting of all cause death, myocardial infarction, or target lesion revascularization. Survival analysis with weighted Kaplan-Meier curves and Cox proportional hazard models were constructed. Double stenting was associated with a significantly higher risk of MACE at three years with a hazard ratio of 1.27 (95% CI 1.08–1.50). Survival analysis has shown a superior outcome in terms of occurrence of MACE in single stenting versus double stenting (P<0.01). Subgroup analysis has shown an amplified risk in higher degree of calcification (hazard ratio 1.42; 95% CI 1.12–1.79) and side branch ostial involvement (hazard ratio HR 1.30; 95% CI 1.08–1.56). Our large cohort has shown that single stenting strategies was associated with significantly better outcome than double stenting strategies.Single versus double stenting survivalFor image description, please refer to the figure legend and surrounding text.