Introduction
Materials and methods
Study population
Coronary intervention
Coronary angiographic analysis
Assessment of clinical follow-up
Definition of clinical endpoints
Statistical analysis
Results
Demographics and cardiovascular risk profile of patients
True bifurcation lesion (TBL) group (n = 116) | Non-true bifurcation lesion (non-TBL) group (n = 171) |
p
| |
---|---|---|---|
Age (years) | 65.4 ± 10.6 | 64.0 ± 10.4 | 0.26 |
Female gender | 30 (25.9) | 44 (25.7) | 0.98 |
Diabetes mellitus | 24 (20.7) | 32 (18.7) | 0.68 |
Arterial hypertension | 64 (55.2) | 90 (52.6) | 0.67 |
Hypercholesterolemia | 60 (54.1) | 87 (51.5) | 0.67 |
Current smoker | 33 (28.4) | 42 (24.6) | 0.46 |
Family history of CAD | 53 (45.7) | 90 (52.6) | 0.25 |
Previous MI | 41 (35.3) | 48 (28.1) | 0.19 |
Previous PCI | 22 (19.0) | 29 (17.0) | 0.66 |
Previous CABG | 12 (10.3) | 11 (6.4) | 0.23 |
Clinical syndrome | 0.97 | ||
Stable angina pectoris | 55 (47.4) | 81 (47.4) | |
Unstable angina | 31 (26.7) | 44 (25.7) | |
Non-ST elevation MI | 30 (25.9) | 46 (27.9) |
Lesion characteristics and interventional procedure
True bifurcation lesion (TBL) group (n = 116) | Non-true bifurcation lesion (non-TBL) group (n = 171) |
p
| |
---|---|---|---|
Lesion characteristics
| |||
De novo lesions | 99 (85.3) | 154 (90.1) | 0.23 |
Severe calcification | 21 (18.1) | 35 (20.5) | 0.62 |
At least one aorto-ostial lesion | 8 (6.9) | 15 (8.8) | 0.57 |
Treated coronary vessels | |||
Left main | 11 (9.5) | 19 (11.1) | 0.66 |
Right coronary artery | 17 (14.7) | 36 (21.1) | 0.17 |
Left anterior descending artery | 91 (78.4) | 124 (72.5) | 0.26 |
Circumflex artery | 41 (35.3) | 62 (36.3) | 0.87 |
Medina classification | <0.01 | ||
0.1.1 | 39 (33.6) | 0 | |
1.0.1 | 18 (15.5) | 0 | |
1.1.1 | 59 (50.9) | 0 | |
0.0.1 | 0 | 25 (14.6) | |
0.1.0 | 0 | 51 (29.8) | |
1.0.0 | 0 | 44 (25.7) | |
1.1.0 | 0 | 51 (29.8) | |
Bifurcation angle (°) | 55.7 ± 22.1 | 62.1 ± 41.0 | 0.14 |
Longest lesion length (mm) | 20.1 ± 11.1 | 20.1 ± 12.3 | 0.78 |
Degree of stenosis before PCI (%) | 67.5 ± 13.3 | 67.1 ± 13.3 | 0.76 |
Residual in-stent stenosis post PCI (%) | 15.2 ± 6.2 | 14.3 ± 6.2 | 0.25 |
Side-branch characteristics | |||
Lumen diameter SB before PCI (mm) | 2.3 ± 0.3 | 2.4 ± 0.4 | 0.01 |
Degree of SB stenosis before PCI (%) | 62.8 ± 13.0 | 65.4 ± 18.8 | 0.40 |
Longest SB lesion length (mm) | 10.0 ± 6.3 | 10.8 ± 8.1 | 0.58 |
Procedural characteristics
| |||
Number of stents per patient | 2.6 ± 1.4 | 2.2 ± 1.2 | 0.01 |
Total stent length per patient (mm) | 50.0 ± 29.8 | 43.4 ± 27.4 | 0.06 |
Predilatation | 90 (77.6) | 115 (67.3) | 0.06 |
Stent postdilatation | 111 (95.2) | 161 (94.2) | 0.57 |
Final kissing balloon inflation | 65 (56.0) | 67 (39.2) | <0.01 |
Single- versus two-stent approach | <0.01 | ||
Single-stent approach | 68 (58.6) | 152 (88.9) | |
Two-stent approach | 48 (41.4) | 19 (11.1) |
Long-term clinical outcome
True bifurcation lesion (TBL) group (n = 115)a
| Non-true bifurcation lesion (non-TBL) group (n = 171) |
p
| |
---|---|---|---|
Adverse clinical events
| |||
All-cause mortality | 10 (8.7) | 6 (3.5) | 0.06 |
Cardiac death | 4 (3.5) | 2 (1.2) | 0.22 |
Any myocardial infarction | 13 (11.3) | 9 (5.3) | 0.06 |
Target-vessel-related myocardial infarction | 13 (11.3) | 9 (5.3) | 0.06 |
Periprocedural myocardial infarction | 11 (9.6) | 8 (4.7) | 0.10 |
Myocardial infarction >48 h post PCI | 2 (1.7) | 1 (0.6) | 0.57 |
Target-lesion revascularization (TLR) | 4 (3.5) | 6 (3.5) | 1.00 |
Emergent coronary bypass surgery | 0 | 0 | |
Definite-or-probable stent thrombosis | 1 (0.9) | 0 | 0.40 |
Composite clinical endpoints
| |||
Target-lesion failure (TLF) | 19 (16.5) | 16 (9.4) | 0.07 |
Major adverse cardiac events (MACE) | 23 (20.0) | 20 (11.7) | 0.05 |