Background The predictive value of bifurcation angle （BA） for worse events after stenting bifurcation lesions remains to be unknown. The present study was to investigate the dynamic change of BA and clinical relevan...Background The predictive value of bifurcation angle （BA） for worse events after stenting bifurcation lesions remains to be unknown. The present study was to investigate the dynamic change of BA and clinical relevance for patients with coronary bifurcation lesions treated by drug-eluting stent （DES）. Methods BA was calculated by 3-D quantitative coronary analysis from 347 patients in DKCRUSH-II study. Primary endpoint was the occurrence of composite major adverse cardiac events （MACE） at 12-month, including cardiac death, myocardial infarction （MI） and target vessel revascularization （TVR）. Secondary end points were the rate of binary restenosis and stent thrombosis at 12-month. Results Stenting was associated with the reduction of distal BA. The cut-off value of distal BA for predicting MACE was 60°. Distal BA in 〈60° group had less reduction after stenting （（-1.96＋13.58）°vs. （-12.12±23.58）°, P 〈0.001）; two-stent technique was associated with significant reduction of distal BA （△（-4.05±14.20）°）, compared to single stent group （4＋1.55±11.73, P=0.003）; the target lesion revascularization （TLR）, TVR and MACE rate was higher in one-stent group （16.5%, 19.0% and 21.5%）, compared to two-stent group （3.8%, P=0.002; 7.5%, P=0.016; and 9.8%, P=0.024）, respectively. Among patients in ≥60° group, there were no significant differences in distal BA, stent thrombosis （ST）, MI, MACE, death, TLR, TVR between one- and two-stent groups; after stenting procedure, there was only slight change of distal BA in left anterior descending （LAD）-Ieft circumflex （LCX） subgroup （from （88.54±21.33）° at baseline to （82.44±31.72）° post-stenting）, compared to either LAD-diagonal branch （Di）, or LCX-obtuse marginal branch （OM）, or IRCA distal （RCAd） （all P 〈0.001 ）. Conclusion Two-stent technique was associated with significant reduction of distal BA. DK crush stenting had reduced rate of MACE in patients in 〈60° group, compared to one-stent technique.展开更多
Background The gender-based differences in adverse events after drug-eluting stent （DES） implantation between Chinese women and men have not been fully studied. The present study aimed to compare the 5-year clinical...Background The gender-based differences in adverse events after drug-eluting stent （DES） implantation between Chinese women and men have not been fully studied. The present study aimed to compare the 5-year clinical outcome after DES implantation in Chinese women and men. Methods Chinese women （n=298） and men （n=698） with newly diagnosed de novo coronary lesions were studied after DES implantation. The primary endpoint was the occurrence of major adverse cardiac events （MACEs） over a 5-year follow-up, including myocardial infarction （MI）, cardiac death, and target vessel revascularization （TVR）. Propensity score matching （PSM） was used to compare the adjusted MACE rates between sexes. Results Women differed in body habitus and had increased fasting cholesterol. Fewer women presented with MI, and they had better cardiac function with less complex disease. The unadjusted rate of MI at 3 years （2.1%） and 5 years （5.0%） and MACE （25.2%） at 5 years in men was significantly higher than that of women （0.3%, 1.0% and 17.8%, P=0.050, P=0.032, and P=0.011, respectively）. After PSM, the adjusted adverse events between sexes were similar. The stent thrombosis rate rapidly increased after 2 years in men. Conclusions There were significant gender-based differences in baseline characteristics. Chinese men had equivalent outcomes to women after DES after adjustment by PSM. The increased rate of MI in men was attributed to an increased unadjusted rate of MACE.展开更多
文摘Background The predictive value of bifurcation angle （BA） for worse events after stenting bifurcation lesions remains to be unknown. The present study was to investigate the dynamic change of BA and clinical relevance for patients with coronary bifurcation lesions treated by drug-eluting stent （DES）. Methods BA was calculated by 3-D quantitative coronary analysis from 347 patients in DKCRUSH-II study. Primary endpoint was the occurrence of composite major adverse cardiac events （MACE） at 12-month, including cardiac death, myocardial infarction （MI） and target vessel revascularization （TVR）. Secondary end points were the rate of binary restenosis and stent thrombosis at 12-month. Results Stenting was associated with the reduction of distal BA. The cut-off value of distal BA for predicting MACE was 60°. Distal BA in 〈60° group had less reduction after stenting （（-1.96＋13.58）°vs. （-12.12±23.58）°, P 〈0.001）; two-stent technique was associated with significant reduction of distal BA （△（-4.05±14.20）°）, compared to single stent group （4＋1.55±11.73, P=0.003）; the target lesion revascularization （TLR）, TVR and MACE rate was higher in one-stent group （16.5%, 19.0% and 21.5%）, compared to two-stent group （3.8%, P=0.002; 7.5%, P=0.016; and 9.8%, P=0.024）, respectively. Among patients in ≥60° group, there were no significant differences in distal BA, stent thrombosis （ST）, MI, MACE, death, TLR, TVR between one- and two-stent groups; after stenting procedure, there was only slight change of distal BA in left anterior descending （LAD）-Ieft circumflex （LCX） subgroup （from （88.54±21.33）° at baseline to （82.44±31.72）° post-stenting）, compared to either LAD-diagonal branch （Di）, or LCX-obtuse marginal branch （OM）, or IRCA distal （RCAd） （all P 〈0.001 ）. Conclusion Two-stent technique was associated with significant reduction of distal BA. DK crush stenting had reduced rate of MACE in patients in 〈60° group, compared to one-stent technique.
文摘Background The gender-based differences in adverse events after drug-eluting stent （DES） implantation between Chinese women and men have not been fully studied. The present study aimed to compare the 5-year clinical outcome after DES implantation in Chinese women and men. Methods Chinese women （n=298） and men （n=698） with newly diagnosed de novo coronary lesions were studied after DES implantation. The primary endpoint was the occurrence of major adverse cardiac events （MACEs） over a 5-year follow-up, including myocardial infarction （MI）, cardiac death, and target vessel revascularization （TVR）. Propensity score matching （PSM） was used to compare the adjusted MACE rates between sexes. Results Women differed in body habitus and had increased fasting cholesterol. Fewer women presented with MI, and they had better cardiac function with less complex disease. The unadjusted rate of MI at 3 years （2.1%） and 5 years （5.0%） and MACE （25.2%） at 5 years in men was significantly higher than that of women （0.3%, 1.0% and 17.8%, P=0.050, P=0.032, and P=0.011, respectively）. After PSM, the adjusted adverse events between sexes were similar. The stent thrombosis rate rapidly increased after 2 years in men. Conclusions There were significant gender-based differences in baseline characteristics. Chinese men had equivalent outcomes to women after DES after adjustment by PSM. The increased rate of MI in men was attributed to an increased unadjusted rate of MACE.
