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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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

Kumsars, Indulis (author): Department of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia

Holm, Niels Ramsing (author): Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Niemelä, Matti (author): Department of Cardiology, Oulu University Hospital, Oulu, Finland

Erglis, Andrejs (author): Research Institute of Cardiology and Regenerative Medicine, Latvia Centre of Cardiology, Riga, Latvia

Kervinen, Kari (author): Department of Cardiology, Oulu University Hospital, Oulu, Finland

Christiansen, Evald Hoj (author): Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Maeng, Michael (author): Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Dombrovskis, Andis (author): Department of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia

Abraitis, Vytautas (author): Department of Cardiology, Vilnius University Hospital, Vilnius, Lithuania

Kibarskis, Aleksandras (author): Department of Cardiology, Vilnius University Hospital, Vilnius, Lithuania

Trovik, Thor (author): Department of Cardiology, University of North Norway, Tromsoe, Norway

Latkovskis, Gustavs (author): Research Institute of Cardiology and Regenerative Medicine, Latvia Centre of Cardiology, Riga, Latvia

Sondore, Dace (author): Department of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia

Narbute, Inga (author): Research Institute of Cardiology and Regenerative Medicine, Latvia Centre of Cardiology, Riga, Latvia

Terkelsen, Christian Juhl (author): Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Eskola, Markku (author): Department of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland

Romppanen, Hannu (author): Department of cardiology, Heart Center, Kuopio University Hospital, Kuopio, Finland

Laine, Mika (author): Department of Cardiology, Helsinki University Central Hospital, Helsinki, Finland

Jensen, Lisette Okkels (author): Department of Cardiology, Odense University Hospital, Odense, Denmark

Pietila, Mikko (author): Department of Cardiology, Turku University Hospital, Turku, Finland

Gunnes, Pal (author): Heart Center, Sørlandet Hospital, Arendal, Norway

Hebsgaard, Lasse (author): Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

Fröbert, Ole, 1964- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology

Calais, Fredrik, 1971- (author): Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiology

Hartikainen, Juha (author): Department of cardiology, Heart Center, Kuopio University Hospital, Kuopio, Finland

Aarøe, Jens (author): Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

Ravkilde, Jan (author): Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

Engstrøm, Thomas (author): Department of Cardiology, Rigshospitalet, Copenhagen, Denmark

Steigen, Terje K. (author): Department of Cardiology, University Hospital of North Norway, Tromsoe and Cardiovascular Diseases Research Group, UiT The Arctic University of Norway, Tromsø, Norway

Thuesen, Leif (author): Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark

Lassen, Jens F. (author): Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark

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2020-01-19
2020
English.
In: Open heart. - : BMJ Publishing Group Ltd. - 2053-3624. ; 7:1

Related links:: https://doi.org/10.1...; show more...; https://openheart.bm...; https://urn.kb.se/re...; https://doi.org/10.1...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

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.

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cardiac and Card ...

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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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