Long term results after percutanous coronary intervention in large cohort of coronary bifurcation lesions in large volume center in single versus double stenting

Background The coronary bifurcation lesion remains a unique challenge for the modern interventionalist. Current outcome data in treatment of bifurcation lesions have shown varying results. Additionally, long-term outcomes remain largely unexplored. Purpose The main objective of this study is to investigate and compare the long-term outcome of patients after percutaneous coronary interventions in bifurcation lesions in single versus double stenting strategies in a large volume center. Methods We analyzed 3991 patients from a large registry undergoing percutaneous coronary interventions for bifurcation lesions for over 3 years. Primary endpoint was major adverse cardiac events (MACE) consisting of all cause death, myocardial infarction, or target lesion revascularization. Survival analysis with weighted Kaplan-Meier curves and Cox proportional hazard models were constructed. Results Double stenting was associated with a significantly higher risk of MACE at three years with a hazard ratio of 1.27 (95% CI 1.08–1.50). Survival analysis has shown a superior outcome in terms of occurrence of MACE in single stenting versus double stenting (P<0.01). Subgroup analysis has shown an amplified risk in higher degree of calcification (hazard ratio 1.42; 95% CI 1.12–1.79) and side branch ostial involvement (hazard ratio HR 1.30; 95% CI 1.08–1.56). Conclusions Our large cohort has shown that single stenting strategies was associated with significantly better outcome than double stenting strategies.