Abstract 15620: Impact of Bifurcation Angle on Major Cardiac Events After Cross Over Single Stent Strategy in Unprotected Left Main Bifurcation Lesion: 3-Dimensional Quantitative Coronary Angiographic Analysis
Background: Several studies had revealed that three dimensional (3D) quantitative coronary angiography (QCA) overcomes the shortcoming of 2-dimensional QCA regarding bifurcation angle analysis. The impact of bifurcation angle (BA) between left main (LM) and left anterior descending artery (LAD) on clinical outcomes after single stenting (LM to LAD) have never been documented. Therefore, we investigated the impact of this angle on clinical outcomes after cross over single stent strategy in this study.
Methods: A total of 170 patients who underwent PCI in unprotected LM bifurcation with successful single cross over stenting from the LM into the LAD were enrolled. The proximal BA (BA between LM and LAD: shown in Fig.A) were computed in end-diastole before PCI with 3D QCA software. The patients were classified into three groups according to the tertile of the proximal BA(low BA group; n=57, middle BA group; n=57, and high BA group; n=56, shown in Fig.B)The cumulative incidence of major adverse cardiac event (MACE: cardiac death, myocardial infarction, any revascularization including target lesion revascularization) rates throughout the 12-month were compared between three groups. For analyzing for predictors of MACE, multivariate analysis was also performed.
Results: Baseline patient characteristics were not significant difference between three groups.Compared to high angle group, the low angle group had significant high incidence of MACE (log rank; p=0.041)(Fig.B). In multivariate analysis, Pre-PCI proximal BA were one of the significant independent predictors of MACE (Hazard ratio: 0.98; 95% confidence interval: 0.97 to 0.99, P=0.0018).
Conclusions: This study revealed that low bifurcation angle between LM and LAD had an adverse clinical impact after single cross over LM to LAD stenting.
- © 2012 by American Heart Association, Inc.