E-Abstract

JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2023. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP A-032

Factors Associated With Major Adverse Cardiovascular Events in Patients Treated by Provisional Stenting for Coronary Artery Bifurcation Lesions

By Walid Jomaa, Taha Lassoued, Ikram Chamtouri, Khaldoun Ben Hamda, Faouzi Maatouk

Presenter

Walid Jomaa

Authors

Walid Jomaa1, Taha Lassoued1, Ikram Chamtouri1, Khaldoun Ben Hamda1, Faouzi Maatouk1

Affiliation

Fattouma Bourguiba University Hospital, Tunisia1
View Study Report
TCTAP A-032
Bifurcation/Left Main Diseases and Intervention

Factors Associated With Major Adverse Cardiovascular Events in Patients Treated by Provisional Stenting for Coronary Artery Bifurcation Lesions

Walid Jomaa1, Taha Lassoued1, Ikram Chamtouri1, Khaldoun Ben Hamda1, Faouzi Maatouk1

Fattouma Bourguiba University Hospital, Tunisia1

Background

Coronary bifurcation lesions (CBL) are complex to treat and are associated with a high risk of procedural failure and major adverse cardiovascular events (MACE). The aim of our study was to investigate clinical and procedural factors associated with MACE at long-term follow-up after percutaneous coronary intervention (PCI) for CBL.

Methods

In this single-center observational study, 166 patients treated for CBL between January 2001 and December 2019 were included (procedures realized between 2007 and 2012 were excluded for lack of data). In all cases, provisional stenting technique was applied. Procedural, twelve-month and long term outcomes were reported. Predictors of MACE were determined using univariate and survival analysis.

Results

Patient mean age was 60.6 ± 9.8 years and 145 (87.3 %) were male. Most frequent cardiovascular risk factors were smoking in 106 (63.9 %), hypertension in 77 (46.4 %), and diabetes in 75 (45.2 %) cases. Clinical presentation was acute coronary syndrome in 91 (54.8 %) patients. After stent placement in the main branch (MB), side branch (SB) balloon opening was performed in 33 (19.8 %) procedures and a final kissing balloon (FKB) in  41 (24.7 %) procedures. Proximal optimisation technique (POT) was performed in 18 procedures (27.6 % of cases since 2015). Recourse to a second stent implantation was reported in four procedures. Overall procedural success was achieved in 125 (75.3 %) procedures. Mean long-term follow-up was 18 months. Factors associated with freedom from MACE in long-term follow-up were age < 75 years (p = 0.017), POT use (p = 0.022), treatment with Clopidogrel (p = 0.018), and angiographic success on the MB (p < 0.001). In survival analysis, occurrence of MACE was significantly lower in patients treated with POT (log rank p = 0.022).

Conclusion

In the current study, provisional stenting for CBL PCI was associated with satisfactory early and long-term outcomes. Young age, POT use, clopidogrel treatment and angiographic success on MB were associated with better long-term outcomes.

Leave Comments