Incidence of bifurcation coronary lesion as a culprit lesion in patients with acute myocardial infarction: impact of treatment strategy on short and long term outcomes

Authors : Hazar HARBALIOĞLU, Caner TURKOGLU, Taner ŞEKER, Alaa QUİSİ, Omer GENC, Gökhan ALICI, Samir ALLAHVERDİYEV, Ahmet Oytun BAYKAN, Mustafa GÜR

Pages : 519-527

Doi:10.31362/patd.706595

View : 25 | Download : 7

Publication Date : 2020-09-18

Article Type : Research Paper

Abstract :Background: Although, there are several studies comparing single and two-stent techniques in patients with bifurcation lesions, evidence in patients presenting with myocardial infarction insert ignore into journalissuearticles values(MI); is still insufficient. We aimed to assess the short and long term outcomes of provisional and two-stent techniques of bifurcation lesions in patients with ACS. Methods: 2992 patients with MI who underwent percutaneous coronary intervention insert ignore into journalissuearticles values(PCI); were enrolled in the present study. Of 2992 patients, 385 patients with MI had bifurcation lesions. The Synergy between PCI with TAXUS™ and Cardiac Surgery insert ignore into journalissuearticles values(SYNTAX); score, pre-PCI Thrombolysis in Myocardial Infarction insert ignore into journalissuearticles values(TIMI); flow, post-PCI TIMI flow, duration of procedure, angiographic features, post-PCI side branch loss, 1- and 12-month mortality rates were noted. Results: 169 insert ignore into journalissuearticles values(43.9 %); patients had ST segment elevation MI, whereas 216 insert ignore into journalissuearticles values(56.1%); patients had non-ST segment elevation MI. 355 insert ignore into journalissuearticles values(92.2%); patients underwent provisional stenting and 30 insert ignore into journalissuearticles values(7.8%); patients underwent two-stent technique. Side branch loss was observed in 40 patients insert ignore into journalissuearticles values(11.2 %); in the provisional group and 1 patient insert ignore into journalissuearticles values(3.3%); in the two-stent group insert ignore into journalissuearticles values(p=0.2);. Compared to provisional group, durations of angiography and revascularization in two-stent group were significantly longer insert ignore into journalissuearticles values(p<0.001 and p<0.001);. Both 1-month and 12-month mortality rates were similar in provisional and two-stent groups insert ignore into journalissuearticles values(4.2% vs. 3.3%, p=0.8 and 11.5% and 13.3%, p=0.7; respectively);. Conclusion: In patients presenting with ACS and bifurcation lesions, procedural success, side branch loss, as well as short and long term mortality were similar in both provisional and two-stent techniques.
Keywords : Akut koroner sendrom, bifurkasyon, revaskülarizasyon, yan dal kaybı, mortalite