中华医学杂志（英文版）2012，Vol.125Issue(12)：2083-2088,6.DOI:10.3760/cma.j.issn.0366-6999.2012.12.001
Coronary bifurcation angle from 3-D predicts clinical outcomes after stenting bifurcation lesions
Coronary bifurcation angle from 3-D predicts clinical outcomes after stenting bifurcation lesions
CHEN Shao-liang 1DING Shi-qing 2Tak W Kwan 3Teguh Santoso 4ZHANG Jun-jie 1YE Fei 1XU Ya-wei 5FU Qiang 6KAN Jing 1Chitprapai Paiboon 7ZHOU Yong8
作者信息
- 1. Department of Cardiology,Nanjing First Hospital,Nanjing Medical University,Nanjing,Jiangsu 210006,China
- 2. Department of Cardiology,Huainan Xinhua Hospital,Huainar,Anhui 232038,China
- 3. Dcpartment of Cardiology,Beth Israel Hospital,NewYork,USA
- 4. Department of Cardiology,Medistra Hospital,University of Indonesia Medical School,Jakarta,Indonesia
- 5. Department of Cardiology,Shanghai 10th People's Hospital,Shanghai 200072,China
- 6. Department of Cardiology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China
- 7. Department of Cardiology,Bangkok General Hospital,Bangkok,Thailand
- 8. Department of Cardiology,Zhangjiagang People's Hospital,Zhangjiagang,Jiangsu 215600,China
- 折叠
摘要
Abstract
Background The predictive value of bifurcation angle (BA) for worse events after stenting bifurcation lesions remains to be unknown.The present study was to investigate the dynamic change of BA and clinical relevance for patients with coronary bifurcation lesions treated by drug-eluting stent (DES).Methods BA was calculated by 3-D quantitative coronary analysis from 347 patients in DKCRUSH-Ⅱ study.Primary endpoint was the occurrence of composite major adverse cardiac events (MACE) at 12-month,including cardiac death,myocardial infarction (MI) and target vessel revascularization (TVR).Secondary end points were the rate of binary restenosis and stent thrombosis at 12-month.Results Stenting was associated with the reduction of distal BA.The cut-off value of distal BAfor predicting MACE was 60° Distal BA in ＜60° group had less reduction after stenting ((-1.96±13.58)° vs.(-12.12±23.58)°,P ＜0.001 ); two-stent technique was associated with significant reduction of distal BA (△(-4.05±14.20)°),compared to single stent group (△+1.55±11.73,P=0.003); the target lesion revascularization (TLR),TVR and MACE rate was higher in one-stent group (16.5％,19.0％ and 21.5％),compared to two-stent group (3.8％,P=0.002; 7.5％,P=0.016; and 9.8％,P=0.024),respectively.Among patients in ≥60° group,there were no significant differences in distal BA,stent thrombosis (ST),MI,MACE,death,TLR,TVR between one- and two-stent groups; after stenting procedure,there was only slight change of distal BA in left anterior descending (LAD)-Ieft circumflex (LCX) subgroup (from (88.54±21.33)° at baseline to (82.44±31.72)° post-stenting),compared to either LAD-diagonal branch (Di),or LCX-obtuse marginal branch (OM),or RCA distal (RCAd) (all P ＜0.001 ).Conclusion Two-stent technique was associated with significant reduction of distal BA.DK crush stenting had reduced rate of MACE in patients in ＜60° group,compared to one-stent technique.关键词
coronary bifurcation lesions/bifurcation angle/major adverse cardiac events/ROC curveKey words
coronary bifurcation lesions/bifurcation angle/major adverse cardiac events/ROC curve引用本文复制引用
CHEN Shao-liang,DING Shi-qing,Tak W Kwan,Teguh Santoso,ZHANG Jun-jie,YE Fei,XU Ya-wei,FU Qiang,KAN Jing,Chitprapai Paiboon,ZHOU Yong..Coronary bifurcation angle from 3-D predicts clinical outcomes after stenting bifurcation lesions[J].中华医学杂志（英文版）,2012,125(12):2083-2088,6.
