Journal
EUROPEAN HEART JOURNAL
Volume 37, Issue 24, Pages 1923-1928Publisher
OXFORD UNIV PRESS
DOI: 10.1093/eurheartj/ehw170
Keywords
Coronary; Bifurcation; Stent; Long-term survival
Categories
Funding
- Boston Scientific
- NHS Culyer R&D grant from Brighton and Sussex University Hospitals NHS Trust
- Cordis/Johnson Johnson Co.
- BBC ONE: Cardiac Research Unit funds at the Sussex Cardiac Centre
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Aims Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study: old, new, and evolving strategies (BBC ONE). Methods and results Both multicentre randomized trials compared simple (provisional T-stenting) vs. complex (culotte, crush, and T-stenting) techniques, using drug-eluting stents. We analysed all-cause death at 5 years. Data were collected from phone follow-up, hospital records, and national mortality tracking. Follow-up was complete for 890 out of 913 patients (97%). Both Simple and Complex groups were similar in terms of patient and lesion characteristics. Five-year mortality was lower among patients who underwent a simple strategy rather than a complex strategy [17 patients (3.8%) vs. 31 patients (7.0%); P = 0.04]. Conclusion For coronary bifurcation lesions, a provisional single-stent approach appears to be associated with lower long-term mortality than a systematic dual stenting technique.
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