Two stent technique in left main bifurcation associated with worse outcome at one year

Аbstract: Importance: despite generally promising outcomes after stenting for unprotected left main coronary artery (ULMCA) disease, the ULMCA bifurcation lesions remain challenging, and their restenosis rate is still relatively high.  Objective: aim of the current study was to analyze possible factors influencing one year MACE rate in distal ULMCA patients. Design, setting and patients: from year 2002 until end of year 2011 at Latvian Centre of Cardiology, Pauls Stradins Clinical University hospital in ULMCA registry 1052 patients were enrolled.  Interventions: In 723 patients distal bifurcations were treated, out of them in 449 patients one year follow-up were completed and those patients were included in current analyses. Main outcome measures: cardiac death, target vessel revascularization (TVR), target lesion revascularization (TLR),  major cardiac adverse events (MACE) were assessed at one year. Results: two stent technique was used in 8,5% of cases. MACE, cardiac death, TVR and TLR rates at one year was 15,6%, 2,9%, 4,7% and 12,9%, respectively. Cardiac death was associated with diabetes mellitus and NSTEMI, however, TLR was associated with SYNTAX score ³30. MACE was associated with NSTEMI and 2 stent technique. True bifurcation was not associated with adverse cardiovascular outcomes. Conclusions: Use of two stent technique and NSTEMI at presentation were associated of MACE at one year in distal ULMCA patients. КEY-WORDS: • stenting  • left main coronary artery • left coronary artery bifurcation Техника двух стентов для лечения поражений бифуркации ствола левой коронарной артерии, связанная с плохим прогнозом в течение одного года наблюдения РЕЗЮМЕ: Актуальность: несмотря на обнадеживающие результаты после стентирования незащищенного ствола левой коронарной артерии (НЗСЛКА), лечение поражений ствола НЗСЛКА остается сложной задачей, а частота рестенозов сохраняется относительно высокой....