Details

Autor(en) / Beteiligte

• Salinas, Pablo
• Mejía-Rentería, Hernán
• Herrera-Nogueira, Raúl
• Jiménez-Quevedo, Pilar
• Nombela-Franco, Luis
• Núñez-Gil, Iván Javier
• Gonzalo, Nieves
• del Trigo, María
• Pérez-Vizcayno, María José
• Quirós, Alicia
• Escaned, Javier
• Macaya, Carlos
• Fernández-Ortiz, Antonio

Titel

Bifurcation Culprit Lesions in ST-segment Elevation Myocardial Infarction: Procedural Success and 5-year Outcome Compared With Nonbifurcation Lesions

Ist Teil von

• Revista española de cardiología (English ed.), 2018-10, Vol.71 (10), p.801-810

Ort / Verlag

Spain

Erscheinungsjahr

2018

Link zum Volltext

Quelle

Free E-Journal (出版社公開部分のみ）

Beschreibungen/Notizen

• Abstract Introduction and objectives We assessed short- and long-term outcomes of primary angioplasty in ST-segment elevation myocardial infarction by comparing bifurcation culprit lesions (BCL) with non-BCL. Methods Observational study with a propensity score matched control group. Among 2746 consecutive ST-segment elevation myocardial infarction patients, we found 274 (10%) patients with BCL. The primary outcome was a composite endpoint including all-cause death, myocardial infarction, coronary artery bypass grafting or target vessel revascularization, assessed at 30-days and 5-years. Results Baseline characteristics showed no differences after propensity matching (1:1). In the BCL group, the most frequent strategy was provisional stenting of the main branch (84%). Compared with the non-BCL group, the procedures were technically more complex in the BCL group in terms of need for balloon dilatation (71% BCL vs 59% non-BCL; P = .003), longer procedural time (70 ± 29 minutes BCL vs 62.8 ± 28.9 minutes non-BCL; P = .004) and contrast use (256.2 ± 87.9 mL BCL vs 221.1 ± 82.3 mL non-BCL; P < .001). Main branch angiographic success was similar (93.4% BCL vs 93.8% non-BCL; P = .86). Thirty-day all-cause mortality was similar between groups: 4.7% BCL vs 5.1% non-BCL; P = .84. At the 5-year follow-up, there were no differences in all-cause death (12% BCL vs 13% non-BCL; P = .95) or the combined event (22% BCL vs 21% non-BCL; P = .43). Conclusions Primary angioplasty of a BCL was technically more complex; however, main branch angiographic success was similar, and there were no differences in long-term prognosis compared with non-BCL patients.