Long-Term Evaluation of Revascularization Strategies for Medina 0.1.0 Left Main Bifurcation Lesions: The LM-CROSSOVER Registry.
Ahmet GunerCemalettin AkmanKoray ÇiloğluKaan GökçeFatih UzunCemil CanSerkan KahramanAhmet Yaşar ÇizgiciArda GulerGökhan DemirciEzgi Gültekin GünerMehmet ErtürkPublished in: Angiology (2023)
The present study aimed to compare long-term outcomes of patients with Medina 0.1.0 left main (LM) bifurcation lesions treated by crossover stenting (COS) versus accurate ostial stenting (AOS). A total of 229 consecutive eligible patients with Medina 0.1.0 LM bifurcation lesions were enrolled and were stratified according to the stenting techniques. The primary end-point was major cardiovascular and cerebral events (MACCE), defined as the combination of all-cause death, target vessel related-myocardial infarction (MI), clinically driven target lesion revascularization (TLR), stroke, or stent thrombosis. COS and AOS were applied to 78 (34%) and 151 (66%) patients, respectively. During a mean of 40.6 ± 21.1 months of follow-up, the rate of MACCE (27.8 vs 12.8%; P =.007) was higher in patients treated with AOS than those treated with the COS technique, mainly driven by more frequent all-cause death (13.9 vs 3.8%, P = .013) and TLR (6.4 vs 15.9%; P = .029). In multivariable Cox regression analysis, AOS strategy was one of the independent predictors of MACCE (odds ratio: 2.166; 95% confidence interval, 1.080-4.340; P = .029). The current study suggests that COS was associated with a better long-term MACCE rate and lower all-cause mortality rate than AOS in patients with Medina 0.1.0 LM bifurcation disease.
Keyphrases
- newly diagnosed
- antiplatelet therapy
- end stage renal disease
- toll like receptor
- inflammatory response
- heart failure
- immune response
- percutaneous coronary intervention
- chronic kidney disease
- ejection fraction
- endovascular treatment
- open label
- coronary artery bypass grafting
- atrial fibrillation
- pulmonary embolism
- high resolution
- randomized controlled trial
- peritoneal dialysis
- nuclear factor
- patient reported outcomes
- mass spectrometry