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International journal of cardiology v.250, 2018년, pp.80 - 85   SCI SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Provisional versus elective two-stent strategy for unprotected true left main bifurcation lesions: Insights from a FAILS-2 sub-study

Kawamoto, Hiroyoshi (IRCCS Ospedale San Raffaele, Milan, Italy ) ; Chieffo, Alaide (IRCCS Ospedale San Raffaele, Milan, Italy ) ; D'Ascenzo, Fabrizio (Citta della Salute e della Scienza, Turin, Italy ) ; Jabbour, Richard J. (IRCCS Ospedale San Raffaele, Milan, Italy ) ; Naganuma, Toru (New Tokyo Hospital, Matsudo, Japan ) ; Cerrato, Enrico (Ospedale degli Infermi Rivoli, Turin, Italy ) ; Ugo, Fabrizio (Ospedale San Giovanni Bosco, Turin, Italy ) ; Pavani, Marco (Citta della Salute e della Scienza, Turin, Italy ) ; Varbella, Ferdinando (Ospedale degli Infermi Rivoli, Turin, Italy ) ; Boccuzzi, Giacomo (Ospedale San Giovanni Bosco, Turin, Italy ) ; Pennone, Mauro (Citta della Salute e della Scienza, Turin, Italy ) ; Garbo, Roberto (Ospedale San Giovanni Bosco, Turin, Italy ) ; Conrotto, Federico (Citta della Salute e della Scienza, Turin, Italy ) ; Biondi-Zoccai, Giuseppe (Sapienza University of Rome, Latina, Italy ) ; D'Amico, Maurizio (Citta della Salute e della Scienza, Turin, Italy ) ; Moretti, Claudio (Citta della Salute e della Scienza, Turin, Italy ) ; Escaned, Javier (Hospital San Carlos, Madrid, Spain ) ; Gaita, Fiorenzo (Citta della Salute e della Scienza, Turin, Italy ) ; Nakamura, Sunao (New Tokyo Hospital, Matsudo, Japan ) ; Colombo, Antonio (IRCCS Ospedale San Raffaele, Milan, Italy ) ;
  • 초록  

    Abstract Background This study sought to investigate the optimal percutaneous coronary intervention (PCI) strategy for true unprotected left main coronary artery (ULMCA) bifurcations. Methods The FAILS-2 was a retrospective multi-center study including patients with ULMCA disease treated with second-generation drug-eluting stents. Of these, we compared clinical outcomes of a provisional strategy (PS; n=216) versus an elective two-stent strategy (E2S; n=161) for true ULMCA bifurcations. The primary endpoint was the incidence of major adverse cardiac events (MACEs) at 3-years. We further performed propensity-score adjustment for clinical outcomes. Results There were no significant differences between the groups in terms of patient and lesion characteristics. 9.7% of patients in the PS group crossed over to a provisional two-stent strategy. MACEs were not significantly different between groups (MACE at 3-year; PS 28.1% vs. E2S 28.9%, adjusted p=0.99). The rates of target lesion revascularization (TLR) on the circumflex artery (LCX) were numerically high in the E2S group (LCX-TLR at 3-years; PS 11.8% vs. E2S 16.6%, adjusted p=0.51). Conclusions E2S was associated with a comparable MACE rate to PS for true ULMCA bifurcations. The rates of LCX-TLR tended to be higher in the E2S group although there was no statistical significance. Condensed abstract This study sought to compare the clinical outcomes of a provisional strategy (PS) with an elective two-stent strategy (E2S) for the treatment of true unprotected left main coronary artery bifurcations. 377 Patients (PS 216 vs. E2S 161 patients) were evaluated, and 9.7% in the PS group crossed over to a two-stent strategy. E2S was associated with a similar major adverse cardiac event rate at 3-years when compared to the PS strategy (PS 28.1% vs. E2S 28.9%, p=0.99). However, the left circumflex artery TLR rate at 3-year tended to be higher in the E2S group (PS 11.8% vs. E2S 16.6%, p=0.51).


  • 주제어

    Unprotected left main coronary artery .   True bifurcation lesions .   Drug-eluting stent .   Percutaneous coronary intervention.  

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