Key result
Age, diabetes, smoking, and renal failure predicted 1- and 12-month mortality (1.9% and 8.2% overall) after bifurcation-PCI, while provisional versus 2-stent strategies did not impact mortality.
Why the study?
Bifurcation-PCI is performed frequently despite lacking extensive evidence to support a definitive strategy for its complexity.
What are the predictors of 1- and 12-month mortality in patients undergoing bifurcation PCI, and does the choice of stenting strategy impact outcomes?
Cohort (n=732)
No
What are the predictors of 1- and 12-month mortality in patients undergoing bifurcation PCI, and does the choice of stenting strategy impact outcomes?
In a real-world cohort of bifurcation PCI, mortality was driven by baseline clinical factors (age, diabetes, smoking, renal failure) rather than the choice between provisional and two-stent strategies.
Baseline risks should guide prognosis after bifurcation PCI; leaves open strategy effects in randomized trials.
Aim: Bifurcation-PCI is performed frequently, although without extensive evidence to back up a definitive solution for its complexity. We set out to identify factors associated with 1- and 12-month mortality after bifurcation-PCI between 2017 and 2021 in our tertiary centre in Wales, UK. Results: Of 732 bifurcation PCI cases (mean age 69; 25% female), 67% were in ACS, 42% were left main PCI and 25.3% involved two-stent strategy. 30-day and 12-month mortality were 1.9% and 8.2%, respectively. Age, diabetes, smoking and renal failure are associated with mortality after bifurcation-PCI, while the choice between provisional and 2-stent strategies did not impact mortality/TLR. Conclusion: Awareness of ‘real-world’ outcomes of bifurcation-PCI should be used for appropriate patient selection, technique planning and procedural consent.
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Protty et al. (2023) conducted a cohort in Bifurcation coronary artery disease (n=732). 2-stent strategy vs. Provisional stenting strategy was evaluated on 1- and 12-month mortality. Age, diabetes, smoking, and renal failure predicted 1- and 12-month mortality (1.9% and 8.2% overall) after bifurcation-PCI, while provisional versus 2-stent strategies did not impact mortality.
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