Key result
Severe LV dysfunction is linked to ~3.2-fold higher mortality after coronary bifurcation PCI.
Why the study?
Coronary bifurcation lesions pose substantial challenges in PCI, motivating this assessment of the clinical and angiographic characteristics and short-term outcomes of patients undergoing bifurcation PCI in a South Asian population.
What are the clinical and angiographic characteristics and predictors of short-term outcomes in South Asian patients undergoing percutaneous coronary intervention for coronary bifurcation lesions?
Observational (n=259)
No
What are the clinical and angiographic characteristics and predictors of short-term outcomes in South Asian patients undergoing percutaneous coronary intervention for coronary bifurcation lesions?
In South Asian patients undergoing coronary bifurcation PCI, severe left ventricular dysfunction—rather than lesion type or stenting strategy—was the sole independent predictor of short-term all-cause mortality.
Answers are grounded in this paper and cite their sources.
Observational South Asian bifurcation PCI data; leaves open generalizability and need for comparative trials before practice change.
Background: Coronary bifurcation lesions pose substantial challenges in percutaneous coronary intervention (PCI). This study aimed to assess the clinical and angiographic characteristics of patients undergoing PCI for bifurcation lesions in a South Asian population and to evaluate short-term outcomes. Methods: This prospective observational study was performed from June 2022 through September 2023 at a tertiary cardiac care center in individuals undergoing PCI for coronary bifurcation lesions. Results: A total of 259 participants were enrolled, with a mean (SD) age of 57.4 (10.9) years; 78.8% were male.The Medina classification indicated that the most common bifurcation lesion was left main–left anterior descending (LM–LAD) (43.2%). A total of 206 participants had LM bifurcation lesions, whereas 53 had non-LM lesions, with the LAD being the most frequently involved culprit vessel (94.2%). Ostial lesions were present in 68.3% of cases, and calcification was significantly more common in LM lesions (14.6%) than in non-LM lesions (1.9%; P=.01). Provisional stenting was the most common technique (62.6%), with double kiss crush used more frequently in LM bifurcation lesions (20.4% vs 3.8%; P < .001). Major adverse cardiovascular events (MACE) occurred in 38 participants (14.7%); they included 18 cardiac deaths (6.9%) and 13 cases of target vessel failure (TVF) (5.0%). No significant differences in MACE (P=.23) or death (P=.10) were observed between bifurcation lesion types or stenting strategies. Intravascular ultrasonography (IVUS) guidance was utlized in 70.3% of participants and was potentially associated with improved outcomes. Kaplan–Meier analysis revealed that severe left ventricular dysfunction was associated with a nearly 3-fold greater risk of death (hazard ratio [HR], 2.96; 95% CI, 0.98 to 8.96) and was the only independent predictor of all-cause mortality (HR, 3.23; 95% CI, 1.14 to 9.14; P=.027). Conclusion: Procedural complexity and lesion-related factors were not significantly associated with short-term mortality. These findings emphasize the importance of addressing myocardial dysfunction in risk stratification and management to improve outcomes in this high-risk population.
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Karwa et al. (2026) conducted an observational in Coronary bifurcation lesions undergoing percutaneous coronary intervention (PCI) (n=259). Percutaneous coronary intervention (PCI) for coronary bifurcation lesions vs. Bifurcation lesion types (LM vs non-LM), stenting strategies, and LV dysfunction severity was evaluated on Major adverse cardiovascular events (MACE) and all-cause mortality (HR 3.23, 95% CI 1.14 to 9.14, p=0.027). Severe LV dysfunction independently predicted all-cause mortality after coronary bifurcation PCI (HR 3.23; 95% CI 1.14-9.14; P=0.027), with 14.7% overall MACE and 6.9% cardiac death.
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