title: Impact of bifurcation lesions on clinical outcome and prognosis of primary angioplasty in acute myocardial infarction.
abstract: OBJECTIVE
  The aim of this study was to determine the impact of bifurcation lesions on outcomes after primary percutaneous intervention (PCI) for acute myocardial infarction.
  
  
  RESULTS
  We retrospectively reviewed a single-centre database of 646 patients admitted for primary angioplasty within 12 hours after AMI. We compared baseline characteristics and outcomes between bifurcation and non-bifurcation lesions. Bifurcation lesions were found in 23% of patients. They predominantly involved the left anterior descending artery. Provisional T-stenting was used in 89.3% of patients (with stenting of the main branch in 82% and of both branches in 7.3%), side-branch protection in 54.6%, and final kissing balloon inflation in 33%. The procedural success rate was 92% for the main branch of bifurcation lesions compared with 93% for non-bifurcation lesions (P=0.65). Major adverse cardiac event (MACE) rates were comparable in the two groups: in-hospital MACE was 13.3% in the bifurcation group versus 11.4% in the non-bifurcation group (P=0.72), and the 1-year total MACE rate was 22.6% in the bifurcation group versus 19.5% in the non-bifurcation group (P=0.56).
  
  
  CONCLUSIONS
  Bifurcation lesions are common in patients with AMI. In a population with AMI, immediate and mid-term outcomes of primary PCI were similar in patients with and without bifurcation lesions.
authors.affiliation: University Hospital Henri Mondor, Créteil, France.
authors.forename: Diaa-Eldin
authors.initials: DE
authors.lastname: Abdel-Hakim
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.forename: Stéphane
authors.initials: S
authors.lastname: Champagne
authors.forename: Fathi
authors.initials: F
authors.lastname: Maklady
authors.forename: Ahmed
authors.initials: A
authors.lastname: el-Hawary
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Dubois-Randé
authors.forename: Pierre-François
authors.initials: PF
authors.lastname: Lesault
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Teiger
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy; D003331:Coronary Vessels / Q000473:pathology*; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome