Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch : the Nordic-Baltic Bifurcation Study IV

Show full item record



Permalink

http://hdl.handle.net/10138/315433

Citation

Nordic Baltic Bifurcation Study , Kumsars , I , Holm , N R , Niemelä , M , Kervinen , K , Eskola , M , Romppanen , H , Laine , M , Pietila , M & Hartikainen , J 2020 , ' Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch : the Nordic-Baltic Bifurcation Study IV ' , Open Heart , vol. 7 , no. 1 , 000947 . https://doi.org/10.1136/openhrt-2018-000947

Title: Randomised comparison of provisional side branch stenting versus a two-stent strategy for treatment of true coronary bifurcation lesions involving a large side branch : the Nordic-Baltic Bifurcation Study IV
Author: Nordic Baltic Bifurcation Study; Kumsars, Indulis; Holm, Niels Ramsing; Niemelä, Matti; Kervinen, Kari; Eskola, Markku; Romppanen, Hannu; Laine, Mika; Pietila, Mikko; Hartikainen, Juha
Other contributor: University of Helsinki, Kardiologian yksikkö

Date: 2020-02
Language: eng
Number of pages: 12
Belongs to series: Open Heart
ISSN: 2053-3624
DOI: https://doi.org/10.1136/openhrt-2018-000947
URI: http://hdl.handle.net/10138/315433
Abstract: Background It is still uncertain whether coronary bifurcations with lesions involving a large side branch (SB) should be treated by stenting the main vessel and provisional stenting of the SB (simple) or by routine two-stent techniques (complex). We aimed to compare clinical outcome after treatment of lesions in large bifurcations by simple or complex stent implantation. Methods The study was a randomised, superiority trial. Enrolment required a SB >= 2.75 mm, >= 50% diameter stenosis in both vessels, and allowed SB lesion length up to 15 mm. The primary endpoint was a composite of cardiac death, non-procedural myocardial infarction and target lesion revascularisation at 6 months. Two-year clinical follow-up was included in this primary reporting due to lower than expected event rates. Results A total of 450 patients were assigned to simple stenting (n = 221) or complex stenting (n=229) in 14 Nordic and Baltic centres. Two-year follow-up was available in 218 (98.6%) and 228 (99.5%) patients, respectively. The primary endpoint of major adverse cardiac events (MACE) at 6 months was 5.5% vs 2.2% (risk differences 3.2%, 95% CI -0.2 to 6.8, p=0.07) and at 2 years 12.9% vs 8.4% (HR 0.63, 95% CI 0.35 to 1.13, p = 0.12) after simple versus complex treatment. In the subgroup treated by newer generation drug-eluting stents, MACE was 12.0% vs 5.6% (HR 0.45, 95% CI 0.17 to 1.17, p = 0.10) after simple versus complex treatment. Conclusion In the treatment of bifurcation lesions involving a large SB with ostial stenosis, routine two-stent techniques did not improve outcome significantly compared with treatment by the simpler main vessel stenting technique after 2 years.
Subject: DUAL ANTIPLATELET THERAPY
EVEROLIMUS-ELUTING STENTS
CONSENSUS DOCUMENT
ARTERY-DISEASE
COMPLEX
INTERVENTION
OUTCOMES
CRUSH
TRIAL
PLACEMENT
3121 General medicine, internal medicine and other clinical medicine
Rights:


Files in this item

Total number of downloads: Loading...

Files Size Format View
e000947.full.pdf 988.0Kb PDF View/Open

This item appears in the following Collection(s)

Show full item record