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

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dc.contributor.author Nordic Baltic Bifurcation Study
dc.contributor.author Kumsars, Indulis
dc.contributor.author Holm, Niels Ramsing
dc.contributor.author Niemelä, Matti
dc.contributor.author Kervinen, Kari
dc.contributor.author Eskola, Markku
dc.contributor.author Romppanen, Hannu
dc.contributor.author Laine, Mika
dc.contributor.author Pietila, Mikko
dc.contributor.author Hartikainen, Juha
dc.date.accessioned 2020-05-28T14:32:01Z
dc.date.available 2020-05-28T14:32:01Z
dc.date.issued 2020-02
dc.identifier.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
dc.identifier.other PURE: 137837840
dc.identifier.other PURE UUID: a16d440c-b3ea-4453-8685-fbcbb790ae1f
dc.identifier.other WOS: 000527748100006
dc.identifier.uri http://hdl.handle.net/10138/315433
dc.description.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. en
dc.format.extent 12
dc.language.iso eng
dc.relation.ispartof Open Heart
dc.rights cc_by_nc
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject DUAL ANTIPLATELET THERAPY
dc.subject EVEROLIMUS-ELUTING STENTS
dc.subject CONSENSUS DOCUMENT
dc.subject ARTERY-DISEASE
dc.subject COMPLEX
dc.subject INTERVENTION
dc.subject OUTCOMES
dc.subject CRUSH
dc.subject TRIAL
dc.subject PLACEMENT
dc.subject 3121 General medicine, internal medicine and other clinical medicine
dc.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 en
dc.type Article
dc.contributor.organization Kardiologian yksikkö
dc.contributor.organization Helsinki University Hospital Area
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1136/openhrt-2018-000947
dc.relation.issn 2053-3624
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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