TY - JOUR
T1 - Comparison of provisional 1-stent and 2-stent strategies in diabetic patients with true bifurcation lesions
T2 - The EES bifurcation study
AU - Meelu, Omar A.
AU - Tomey, Matthew I.
AU - Sartori, Samantha
AU - Kherada, Nisharahmed
AU - Mennuni, Marco G.
AU - Theodoropoulos, Kleanthis N.
AU - Sayeneni, Swapna
AU - Baber, Usman
AU - Pyo, Robert T.
AU - Kovacic, Jason C.
AU - Moreno, Pedro
AU - Krishnan, Prakash
AU - Mehran, Roxana
AU - Dangas, George D.
AU - Kini, Annapoorna S.
AU - Sharma, Samin K.
PY - 2014/12/1
Y1 - 2014/12/1
N2 - 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.
AB - 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.
KW - EES
KW - Percutaneous coronary intervention
KW - bifurcation lesion
KW - diabetes mellitus
UR - http://www.scopus.com/inward/record.url?scp=84916931598&partnerID=8YFLogxK
M3 - Article
C2 - 25480989
AN - SCOPUS:84916931598
SN - 1042-3931
VL - 26
SP - 619
EP - 623
JO - Journal of Invasive Cardiology
JF - Journal of Invasive Cardiology
IS - 12
ER -