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Association of Abnormal Left Ventricular Functional Reserve With Outcome in Heart Failure With Preserved Ejection Fraction The Year in Cardiovascular Medicine 2020: Imaging: Looking back on the Year in Cardiovascular Medicine for 2020 in the field of imaging are Fausto Pinto, José Luis Zamorano and Chiara Bucciarelli-Ducci. Judy Ozkan speaks with them Age-Related Characteristics and Outcomes of Patients With Heart Failure With Preserved Ejection Fraction Baseline Features of the VICTORIA (Vericiguat Global Study in Subjects With Heart Failure With Reduced Ejection Fraction) Trial Modifiable lifestyle factors and heart failure: A Mendelian randomization study Burden of Cardiovascular Diseases in China, 1990-2016: Findings From the 2016 Global Burden of Disease Study Coronary plaque redistribution after stent implantation is determined by lipid composition: A NIRS-IVUS analysis Natriuretic Peptide-Guided Heart Failure Therapy After the GUIDE-IT Study Comparison of paclitaxel-eluting stents (Taxus) and everolimus-eluting stents (Xience) in left main coronary artery disease with 3 years follow-up (from the ESTROFA-LM registry) In-stent neoatherosclerosis: a final common pathway of late stent failure
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Clinical Trial2014 Mar;7(3):255-63.

JOURNAL：JACC Cardiovasc Interv. Article Link

Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II

Song YB, Hahn JY, Gwon HC et al. Keywords: angioplasty; bifurcation lesions; drug-eluting stent(s); left main

ABSTRACT


OBJECTIVES - The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions.


BACKGROUND - Few studies have considered anatomic location when comparing 1- and 2-stent strategies for bifurcation lesions.

METHODS - We compared the prognostic impact of treatment strategies on clinical outcomes in 2,044 patients with non-LM bifurcation lesions and 853 with LM bifurcation lesions. The primary outcome was target lesion failure (TLF) defined as a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization.

RESULTS - The 2-stent strategy was used more frequently in the LM bifurcation group than in the non-LM bifurcation group (40.3% vs. 20.8%, p < 0.01). During a median follow-up of 36 months, the 2-stent strategy was not associated with a higher incidence of cardiac death (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 0.72 to 2.14; p = 0.44), cardiac death or MI (HR: 1.12; 95% CI: 0.58 to 2.19; p = 0.73), or TLF (HR: 1.39; 95% CI: 0.99 to 1.94; p = 0.06) in the non-LM bifurcation group. In contrast, in patients with LM bifurcation lesions, the 2-stent strategy was associated with a higher incidence of cardiac death (HR: 2.43; 95% CI: 1.05 to 5.59; p = 0.04), cardiac death or MI (HR: 2.09; 95% CI: 1.08 to 4.04; p = 0.03), as well as TLF (HR: 2.38; 95% CI: 1.60 to 3.55; p < 0.01). Significant interactions were present between treatment strategies and bifurcation lesion locations for TLF (p = 0.01).

CONCLUSIONS - The 1-stent strategy, if possible, should initially be considered the preferred approach for the treatment of coronary bifurcation lesions, especially LM bifurcation lesions. (Korean Coronary Bifurcation Stenting [COBIS] Registry II; NCT01642992).

Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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