title: Coronary bifurcation lesions treated with simple or complex stenting: 5-year survival from patient-level pooled analysis of the Nordic Bifurcation Study and the British Bifurcation Coronary Study.
abstract: Randomized trials of coronary bifurcation stenting have shown better outcomes from a simple (provisional) strategy rather than a complex (planned two-stent) strategy in terms of short-term efficacy and safety. Here, we report the 5-year all-cause mortality based on pooled patient-level data from two large bifurcation coronary stenting trials with similar methodology: the Nordic Bifurcation Study (NORDIC I) and the British Bifurcation Coronary Study: old, new, and evolving strategies (BBC ONE).
  
  
  
  Both multicentre randomized trials compared simple (provisional T-stenting) vs. complex (culotte, crush, and T-stenting) techniques, using drug-eluting stents. We analysed all-cause death at 5 years. Data were collected from phone follow-up, hospital records, and national mortality tracking. Follow-up was complete for 890 out of 913 patients (97%). Both Simple and Complex groups were similar in terms of patient and lesion characteristics. Five-year mortality was lower among patients who underwent a simple strategy rather than a complex strategy [17 patients (3.8%) vs. 31 patients (7.0%); P = 0.04].
  
  
  
  For coronary bifurcation lesions, a provisional single-stent approach appears to be associated with lower long-term mortality than a systematic dual stenting technique.
authors.affiliation: Department of Cardiology, Edinburgh Heart Centre, Royal Infirmary of Edinburgh, Edinburgh EH16 4SA, UK milesbehan@hotmail.com.
authors.forename: Miles W
authors.initials: MW
authors.lastname: Behan
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors.forename: Niels R
authors.initials: NR
authors.lastname: Holm
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: de Belder
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
authors.forename: James
authors.initials: J
authors.lastname: Cockburn
authors.affiliation: Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors.forename: Andrejs
authors.initials: A
authors.lastname: Erglis
authors.affiliation: Southampton University Hospitals & Faculty of Medicine, University of Southampton, Southampton, UK.
authors.forename: Nicholas P
authors.initials: NP
authors.lastname: Curzen
authors.affiliation: Division of Cardiology, Department of Medicine, Oulu University Hospital, Oulu, Finland.
authors.forename: Matti
authors.initials: M
authors.lastname: Niemelä
authors.affiliation: Golden Jubilee National Hospital, Glasgow, UK.
authors.forename: Keith G
authors.initials: KG
authors.lastname: Oldroyd
authors.affiliation: Division of Cardiology, Department of Medicine, Oulu University Hospital, Oulu, Finland.
authors.forename: Kari
authors.initials: K
authors.lastname: Kervinen
authors.affiliation: Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia.
authors.forename: Indulis
authors.initials: I
authors.lastname: Kumsars
authors.affiliation: Feiring Heart Centre, Feiring, Norway.
authors.forename: Paal
authors.initials: P
authors.lastname: Gunnes
authors.affiliation: Liverpool Heart and Chest Hospital, Liverpool, UK.
authors.forename: Rodney H
authors.initials: RH
authors.lastname: Stables
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors.forename: Michael
authors.initials: M
authors.lastname: Maeng
authors.affiliation: Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Jan
authors.initials: J
authors.lastname: Ravkilde
authors.affiliation: Gentofte University Hospital, Gentofte, Denmark.
authors.forename: Jan Skov
authors.initials: JS
authors.lastname: Jensen
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors.forename: Evald H
authors.initials: EH
authors.lastname: Christiansen
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
authors.forename: Nina
authors.initials: N
authors.lastname: Cooter
authors.affiliation: University Hospital of Tromsoe, Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway.
authors.forename: Terje K
authors.initials: TK
authors.lastname: Steigen
authors.affiliation: Heart Center, Tampere University Hospital, Tamper University, Finland.
authors.forename: Saila
authors.initials: S
authors.lastname: Vikman
authors.affiliation: Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Leif
authors.initials: L
authors.lastname: Thuesen
authors.affiliation: Department of Cardiology, Aarhus University Hospital, Skejby, Aarhus, Denmark.
authors.forename: Jens Flensted
authors.initials: JF
authors.lastname: Lassen
authors.affiliation: Sussex Cardiac Centre, Brighton and Sussex University Hospitals, Brighton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Hildick-Smith
mesh_terms: D003324:Coronary Artery Disease; D006801:Humans; D015607:Stents; D013997:Time Factors; D016896:Treatment Outcome
keywords: Bifurcation; Coronary; Long-term survival; Stent