title: Impact of the bifurcation angle on major cardiac events after cross-over single stent strategy in unprotected left main bifurcation lesions: 3-dimensional quantitative coronary angiographic analysis.
abstract: The impact of the bifurcation angle (BA) between the left main (LM) and the main branch on clinical outcomes after single stenting has never been documented. Therefore, the aim of this study was to investigate the impact of the BA on clinical outcomes after single cross-over LM to left anterior descending artery (LAD) stenting. A total of 170 patients who underwent percutaneous coronary intervention (PCI) in unprotected LM bifurcation with successful single cross-over stenting from the LM into the LAD were enrolled. The main vessel angle between the LM and the LAD was computed in end-diastole before PCI with three-dimensional (3D) quantitative coronary angiography (QCA) software. The patients were classified into three groups according to tertiles of the main vessel angle. The cumulative incidence of major adverse cardiac event (MACE: cardiac death, myocardial infarction, any revascularization including target lesion revascularization) rates throughout a 12-month period were compared between the three groups. Baseline patient characteristics were not a significant difference between the three groups. Compared to the high angle group, the low angle group had a significantly higher incidence of MACE (p = 0.041). In conclusion, this study revealed that low BA between the LM and the LAD had an adverse clinical impact after single cross-over LM to LAD stenting.
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Kisaki
authors: K
authors: Amemiya
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Takenori
authors: T
authors: Domei
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Masashi
authors: M
authors: Iwabuchi
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Shinichi
authors: S
authors: Shirai
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Kenji
authors: K
authors: Ando
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Masahiko
authors: M
authors: Goya
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Hiroyoshi
authors: H
authors: Yokoi
authors: Department of Cardiology, Kokura Memorial Hospital Kitakyushu, Japan.
authors: Masakiyo
authors: M
authors: Nobuyoshi
keywords: Coronary artery disease; bifurcation angle; left main bifurcation lesion; percutaneous coronary intervention; three-dimensional quantitative coronary angiography
references: Int J Cardiol. 2009 Apr 17;133(3):321-6
references: 18342960
references: J Am Coll Cardiol. 2005 Feb 1;45(3):351-6
references: 15680711
references: Catheter Cardiovasc Interv. 2007 Feb 1;69(2):172-80
references: 17191235
references: Int J Card Imaging. 2000 Dec;16(6):413-27
references: 11482706
references: Circulation. 2011 Feb 15;123(6):621-30
references: 21282495
references: Circ J. 2009 Nov;73(11):2036-41
references: 19713648
references: Arch Pathol Lab Med. 1988 Oct;112(10):1018-31
references: 3052352
references: Catheter Cardiovasc Interv. 2008 Jan 1;71(1):44-50
references: 18098181
references: J R Soc Interface. 2012 Jun 7;9(71):1187-93
references: 22112654
references: Kardiol Pol. 2008 Apr;66(4):371-8; discussion 379
references: 18473265
references: Am J Cardiol. 2013 Mar 1;111(5):770-3
references: 23291090
references: Circ J. 2007 Nov;71(11):1669-77
references: 17965483
references: Rev Esp Cardiol. 2010 Aug;63(8):904-14
references: 20738935
references: Biomed Eng Online. 2005 Oct 26;4:59
references: 16250918
references: JACC Cardiovasc Interv. 2013 Dec;6(12):1242-9
references: 24355114
references: Am Heart J. 2007 Aug;154(2):336-43
references: 17643585
references: N Engl J Med. 2009 Mar 5;360(10):961-72
references: 19228612
references: JACC Cardiovasc Interv. 2010 Jan;3(1):41-8
references: 20129567
references: Circ J. 2006 Jul;70(7):936-8
references: 16799252
references: J Appl Physiol (1985). 2010 Aug;109 (2):532-40
references: 20507966
references: J Invasive Cardiol. 2013 Mar;25(3):118-22
references: 23468439
references: JACC Cardiovasc Interv. 2014 Jan;7(1):29-36
references: 24332416
references: Int J Cardiol. 2009 Jan 9;131(2):212-6
references: 18241940
references: EuroIntervention. 2011 Sep;7(5):629-35
references: 21930468
references: J Am Coll Cardiol. 2010 Oct 19;56(17):1366-75
references: 20946993
references: Catheter Cardiovasc Interv. 2008 Feb 1;71(2):175-83
references: 17985377
references: Circulation. 2006 Oct 31;114(18):1955-61
references: 17060387
references: JACC Cardiovasc Interv. 2013 Dec;6(12 ):1250-60
references: 24355115
references: Catheter Cardiovasc Interv. 2007 Feb 15;69(3):380-6
references: 17195199
references: Curr Probl Cardiol. 2004 Mar;29(3):104-42
references: 15048057
references: J Am Coll Cardiol. 2010 Apr 20;55(16):1679-87
references: 20394871
references: Circ J. 2011;75(8):1878-84
references: 21628832
references: Am Heart J. 2006 Oct;152(4):762-9
references: 16996856
references: Circulation. 2010 Mar 16;121(10):1235-43
references: 20194880
references: Catheter Cardiovasc Interv. 2007 Feb 15;69(3):387-94
references: 17195203
references: JACC Cardiovasc Interv. 2010 Jun;3(6):595-601
references: 20630452
references: J Am Coll Cardiol. 2008 Jun 10;51(23):2212-9
references: 18534266
references: Am J Physiol Heart Circ Physiol. 2005 May;288(5):H2465-75
references: 15653759
references: Int J Card Imaging. 1999 Oct;15(5):339-53; discussion 355-6
references: 10595401