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Predescu L, Postu M, Zarma L, Bucsa A, Platon P, Croitoru M, Mereuta A, Licheardopol L, Predescu A, Dorobantu D, Deleanu D. Unprotected Left Main Bifurcation Stenting in Acute Coronary Syndromes: Two-Stent Technique versus One-Stent Technique. J Pers Med 2023; 13:jpm13040670. [PMID: 37109056 PMCID: PMC10145714 DOI: 10.3390/jpm13040670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/04/2023] [Accepted: 04/14/2023] [Indexed: 04/29/2023] Open
Abstract
AIMS There is little evidence guiding the choice between a one-stent and a two-stent approach in unprotected distal left main coronary artery disease (UDLMCAD) presenting as acute coronary syndrome (ACS). We aim to compare these two techniques in an unselected ACS group. METHODS AND RESULTS We conducted a single center retrospective observational study, that included all patients with UDLMCAD and ACS undergoing PCI between 2014 and 2018. Group A underwent PCI with a one-stent technique (n = 41, 58.6%), Group B with a two-stent technique (n = 29, 41.4%). A total of 70 patients were included, with a median age of 63 years, including n = 12 (17.1%) with cardiogenic shock. There were no differences between Group A and B in terms of patient characteristics, including SYNTAX score (median 23). The 30-day mortality was 15.7% overall, and was lower in Group B (3.5% vs. 24.4%, p = 0.02). Mortality rate at 4 years was significantly lower in Group B (21.4% vs. 44%), also when adjusted in a multivariable regression model (HR 0.26, p = 0.01). CONCLUSIONS In our study, patients with UDLMCAD and ACS undergoing PCI using a two-stent technique had lower early and midterm mortality compared to one-stent approach, even after adjusting for patient-related or angiographic factors.
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Affiliation(s)
- Lucian Predescu
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Marin Postu
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
| | - Lucian Zarma
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
| | - Adrian Bucsa
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
| | - Pavel Platon
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | - Marian Croitoru
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
| | - Adrian Mereuta
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
- Faculty of Medicine, "Carol Davila" University of Medicine and Pharmacy, 050474 Bucharest, Romania
| | | | | | - Dan Dorobantu
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
- Faculty of Health Sciences, University of Bristol, Bristol BS8 1QU, UK
| | - Dan Deleanu
- Cardiology Department, "Prof. CC Iliescu" Institute for Cardiovascular Diseases, 022328 Bucharest, Romania
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