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  • Kumsars, IndulisDepartment of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia (author)

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

  • Article/chapterEnglish2020

Publisher, publication year, extent ...

  • 2020-01-19
  • BMJ Publishing Group Ltd,2020
  • printrdacarrier

Numbers

  • LIBRIS-ID:oai:DiVA.org:oru-81576
  • https://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-81576URI
  • https://doi.org/10.1136/openhrt-2018-000947DOI

Supplementary language notes

  • Language:English
  • Summary in:English

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  • Subject category:ref swepub-contenttype
  • Subject category:art swepub-publicationtype

Notes

  • Funding Agency:Cordis Corp
  • 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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Added entries (persons, corporate bodies, meetings, titles ...)

  • Holm, Niels RamsingDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark (author)
  • Niemelä, MattiDepartment of Cardiology, Oulu University Hospital, Oulu, Finland (author)
  • Erglis, AndrejsResearch Institute of Cardiology and Regenerative Medicine, Latvia Centre of Cardiology, Riga, Latvia (author)
  • Kervinen, KariDepartment of Cardiology, Oulu University Hospital, Oulu, Finland (author)
  • Christiansen, Evald HojDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark (author)
  • Maeng, MichaelDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark (author)
  • Dombrovskis, AndisDepartment of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia (author)
  • Abraitis, VytautasDepartment of Cardiology, Vilnius University Hospital, Vilnius, Lithuania (author)
  • Kibarskis, AleksandrasDepartment of Cardiology, Vilnius University Hospital, Vilnius, Lithuania (author)
  • Trovik, ThorDepartment of Cardiology, University of North Norway, Tromsoe, Norway (author)
  • Latkovskis, GustavsResearch Institute of Cardiology and Regenerative Medicine, Latvia Centre of Cardiology, Riga, Latvia (author)
  • Sondore, DaceDepartment of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, Latvia (author)
  • Narbute, IngaResearch Institute of Cardiology and Regenerative Medicine, Latvia Centre of Cardiology, Riga, Latvia (author)
  • Terkelsen, Christian JuhlDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark (author)
  • Eskola, MarkkuDepartment of Cardiology, Heart Center, Tampere University Hospital, Tampere, Finland (author)
  • Romppanen, HannuDepartment of cardiology, Heart Center, Kuopio University Hospital, Kuopio, Finland (author)
  • Laine, MikaDepartment of Cardiology, Helsinki University Central Hospital, Helsinki, Finland (author)
  • Jensen, Lisette OkkelsDepartment of Cardiology, Odense University Hospital, Odense, Denmark (author)
  • Pietila, MikkoDepartment of Cardiology, Turku University Hospital, Turku, Finland (author)
  • Gunnes, PalHeart Center, Sørlandet Hospital, Arendal, Norway (author)
  • Hebsgaard, LasseDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark (author)
  • Fröbert, Ole,1964-Örebro universitet,Institutionen för medicinska vetenskaper,Department of Cardiology(Swepub:oru)oft (author)
  • Calais, Fredrik,1971-Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiology(Swepub:oru)fcs (author)
  • Hartikainen, JuhaDepartment of cardiology, Heart Center, Kuopio University Hospital, Kuopio, Finland (author)
  • Aarøe, JensDepartment of Cardiology, Aalborg University Hospital, Aalborg, Denmark (author)
  • Ravkilde, JanDepartment of Cardiology, Aalborg University Hospital, Aalborg, Denmark (author)
  • Engstrøm, ThomasDepartment of Cardiology, Rigshospitalet, Copenhagen, Denmark (author)
  • Steigen, Terje K.Department of Cardiology, University Hospital of North Norway, Tromsoe and Cardiovascular Diseases Research Group, UiT The Arctic University of Norway, Tromsø, Norway (author)
  • Thuesen, LeifDepartment of Cardiology, Aalborg University Hospital, Aalborg, Denmark (author)
  • Lassen, Jens F.Department of Cardiology, Aarhus University Hospital, Aarhus, Denmark (author)
  • Department of Cardiology, Latvia Center of Cardiology, Paul Stradins Clinical University Hospital, Riga, LatviaDepartment of Cardiology, Aarhus University Hospital, Aarhus, Denmark (creator_code:org_t)

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  • In:Open heart: BMJ Publishing Group Ltd7:12053-3624

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