Intracoronary Electrocardiography-guided Strategy for the Treatment of Coronary Bifurcation Lesions  

作　　者：Dobrin Vassilev Niya Mileva Panayot Panayotov Krasimir Kostov Kenan Yumerov Nikolay Petkov Carlos Collet Gianluca Rigatelli Robert J.Gil Thach Nguyen 

机构地区：[1]Medica Cor Hospital,Ruse,Bulgaria [2]Ruse University“Angel Kanchev”,Ruse,Bulgaria [3]Medical Faculty,Medical University Sofia,Sofia,Bulgaria [4]Cardiovascular Center,OLV,Aalst,Belgium [5]Ospedali Riuniti Padova Sud,Padova,Italy [6]Department of Invasive Cardiology,Central Clinical Hospital of the Ministry of Interior,Warsaw,Poland [7]Cardiovascular Research Laboratories,Methodist Hospital,Merrillville,IN,USA

出　　处：《Cardiovascular Innovations and Applications》2023年第1期469-481,共13页心血管创新与应用(英文)

摘　　要：Introduction:Revascularization of bifurcation lesions remains an interventional challenge.Intracoronary electrocar-diograms can predict the functional significance of side branch stenosis after bifurcation stenting.Aim:This study was aimed at evaluating the effects of an intracoronary ECG electrocardiography(icECG)-guided revascularization strategy,compared with the currently accepted standard of care,on the clinical outcomes of patients after coronary bifurcation stenting.Methods:Patients with coronary bifurcation lesions who underwent percutaneous revascularization were enrolled in a prospective all-comers’registry.Clinical outcomes were compared between patients who underwent icECG-guided revascularization versus the current standard of care(SOC),provisional stenting.Results:A total of 768 patients were included in the analysis:349 were treated with an icECG-guided strategy,and 419 received SOC.The overall all-cause death rate was 23.2%,and the cardiovascular death rate was 15.9%.Patients with icECG guidance had significantly lower all-cause mortality(20.3%vs.25.5%for icECG vs.SOC,log-rank P=0.006)and cardiovascular mortality(12.6%vs.18.6%for icECG vs.SOC,log-rank P=0.004).The decrease in mortality was most pronounced in patients with no increase or a moderate increase in troponin post-PCI,or with higher-than-normal baseline troponin concentrations.Conclusion:An icECG-guided strategy for coronary bifurcation PCI led to lower patient mortality than the provi-sional stenting strategy.

关 键 词：Coronary bifurcation percutaneous coronary intervention clinical outcomes 

分 类 号：R54[医药卫生—心血管疾病] R541.4[医药卫生—内科学]