title: Impact of angiographic & procedural factors on the treatment of ostial LAD or LC(x) disease.
abstract: OBJECTIVE
  This study was designed to evaluate the impact of angiographic & procedural factors on MACE after DES deployment in ostial lesions of LAD & LC(x). PATIENTS, MATERIALS & METHODS: 65 patients with ostial disease of LAD or LC(x) underwent PCI using DES. In 56 patients the stent was placed perfectly at the ostium & in 9 patients the LMCA was covered as per protocol. Angiographically 48 patients had a bifurcation angle > 70 degrees whereas in 17 patients the angle was < 70 degrees. RESULT & ANALYSIS: Multivariate Regression Analysis was done. Mean age was 59 years & 77% were male patients. 69% were hypertensives & 52% diabetics. LAD was treated in 88%. 74% had bifurcation angle > 70 degrees. 26% presented with an angle < 70 degrees LMCA was covered during stent implantation in 12% of cases. Average follow up was 1.5 +/- 0.8 years. Overall MACE was 12%. Bifurcation angle > 70 degrees & use of Cypher stent remained significant in reduction of MACE (P < 0.05). Using Univariate analysis of 2 sample sets like cases with angle of separation > 70 degrees (n = 48) & with angle less than < 70 degrees (n = 17), it was found that covering LMCA was beneficial in cases with angle of separation < 70 degres (p-value and correlation coefficient nearer to statistical significance).
  
  
  CONCLUSIONS
  Angiographic factors like bifurcation angle is important to formulate the strategy of stenting procedure in the ostial disease of LAD or LC(x) even with DES.
authors.affiliation: Dept.of Cardiology, A.M.R.I., Salt Lake, Kolkata, West Bengal, India. drsubhananroy@yahoo.com
authors.forename: Shuvanan
authors.initials: S
authors.lastname: Ray
authors.forename: Bhabani Prasad
authors.initials: BP
authors.lastname: Chattopadhyay
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Bandyopadhyay
authors.forename: Subhas
authors.initials: S
authors.lastname: Kundu
authors.forename: Animesh
authors.initials: A
authors.lastname: Deb
authors.forename: P K
authors.initials: PK
authors.lastname: Deb
authors.forename: Amal Kumar
authors.initials: AK
authors.lastname: Bannerjee
authors.forename: Susruta
authors.initials: S
authors.lastname: Bandyopadhyay
mesh_terms: D017023:Coronary Angiography / Q000009:adverse effects; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000379:methods*; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome