Impact of bifurcation angle on mace after cross over single drug-eluting stent strategy in unprotected left main bifurcation lesion: 3-dimensional quantitative coronary angiographic analysis

Abstract

Purpose: 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) in left main (LM) on clinical outcomes after single stenting treated with drug-eluting stent (DES) have never been documented. The Aim of this study was to investigate the impact of unprotected LM bifurcation angle on clinical outcomes after cross over single stent strategy using DES with 3D QCA. Methods: A total of 152 patients who underwent PCI in unprotected LM bifurcation with successful single cross over DES stenting from the LM into the left anterior descending artery (LAD) were enrolled. The distal BA (between LAD and left circumflex [LCX]: shown in Fig) were computed in end-diastole before PCI with 3D QCA software. The patients were diveded into two groups with median value of the distal BA (high-angle group; BA≥86.04°, low-angle group; BA<86.04°) and cumulative incidence of major adverse cardiac and cardiovascular event (MACE: cardiac death, myocardial infarction, any target lesion revascularization) rate were stratified between two groups. Results: Mean follow up duration was 353±51.3 days. Compared to high angle group, the low angle group had significant high incidence of MACE (p=0.0086) (Fig. 1). ![Figure][1] Figure 1 Conclusion: Pre-PCI distal bifurcation angle and proximal bifurcation angle were independent predictors of MACE after single stent strategy cross over LM to LAD using DES. [1]: pending:yes