Serkan Kahraman, Muzaffer Değertekin, Can Yücel Karabay, Mehmet Akif Erdöl, Hasan Arı, Eser Durmaz, Ertuğrul Okuyan, Regayip Zehir, Ali Rıza Akyüz, Çağrı Yayla, İrfan Şahin, Cansu Ebren, Gökhan Demirci, Ahmet Güner, Yunus Emre Erata, Mustafa Ali Yavaş, Ahmet Göktuğ Ertem, Mustafa Azmi Sungur, Bilal Mete Ülker, Ahmet Ceyhun Cebeci, Ali Nural, Büşra Güvendi, Ahmet Oğuz Aslan, İshak Yılmaz, Ali Kemal Kalkan, Mehmet Ertürk
{"title":"非左主干分叉病变不同支架置入技术的指南建议依从性和临床结果。","authors":"Serkan Kahraman, Muzaffer Değertekin, Can Yücel Karabay, Mehmet Akif Erdöl, Hasan Arı, Eser Durmaz, Ertuğrul Okuyan, Regayip Zehir, Ali Rıza Akyüz, Çağrı Yayla, İrfan Şahin, Cansu Ebren, Gökhan Demirci, Ahmet Güner, Yunus Emre Erata, Mustafa Ali Yavaş, Ahmet Göktuğ Ertem, Mustafa Azmi Sungur, Bilal Mete Ülker, Ahmet Ceyhun Cebeci, Ali Nural, Büşra Güvendi, Ahmet Oğuz Aslan, İshak Yılmaz, Ali Kemal Kalkan, Mehmet Ertürk","doi":"10.14744/AnatolJCardiol.2025.5258","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) for coronary bifurcation lesions (CBLs) is a challenging procedure. The optimal stenting technique is still debated. The importance of adherence to current guideline recommendations on clinical outcomes has not yet been clarified. The authors' aim is to investigate the impact of guideline recommendations on clinical outcomes in PCI of CBL.</p><p><strong>Methods: </strong>This was a retrospective, multicenter, observational registry that enrolled patients with true CBL undergoing PCI with provisional or 2-stent techniques. All techniques were evaluated according to the current guideline recommendations. The primary endpoint of the study was target lesion failure (TLF) as a composite endpoint of target lesion revascularization (TLR), target vessel myocardial infarction (TVMI), and cardiac death.</p><p><strong>Results: </strong>A total of 1407 patients were enrolled, and the incidence of TLF, TLR, TVMI, and cardiac death were similar in provisional and 2-stent techniques. However, the incidence of TLF was higher in 2-stent (16.1%) compared to provisional (9.1%) if the guideline recommendations were not followed (HR:1.779; 95%CI: 1.187-2.668, P = .005). The incidence of TLF was lower in 2-stent (4.7%) compared to provisional (9.1%) if the guideline recommendations were followed (HR:0.501; 95% CI: 0.306-0.821, P = .005), mainly driven by reduced TLR (8.1% vs. 3.4%) (HR: 0.398; 95% CI: 0.228-0.696, P = .001) and TVMI (4.5% vs. 2.4%) (HR: 0.503; 95% CI: 0.250-1.011, P = .049).</p><p><strong>Conclusion: </strong>Adherence to current guideline recommendations is the main determinant of clinical outcomes in the PCI of CBLs rather than the selected techniques.</p>","PeriodicalId":7835,"journal":{"name":"Anatolian Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":1.5000,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adherence to Guideline Recommendations and Clinical Outcomes of Different Stenting Techniques in Non-Left Main Bifurcation Lesions.\",\"authors\":\"Serkan Kahraman, Muzaffer Değertekin, Can Yücel Karabay, Mehmet Akif Erdöl, Hasan Arı, Eser Durmaz, Ertuğrul Okuyan, Regayip Zehir, Ali Rıza Akyüz, Çağrı Yayla, İrfan Şahin, Cansu Ebren, Gökhan Demirci, Ahmet Güner, Yunus Emre Erata, Mustafa Ali Yavaş, Ahmet Göktuğ Ertem, Mustafa Azmi Sungur, Bilal Mete Ülker, Ahmet Ceyhun Cebeci, Ali Nural, Büşra Güvendi, Ahmet Oğuz Aslan, İshak Yılmaz, Ali Kemal Kalkan, Mehmet Ertürk\",\"doi\":\"10.14744/AnatolJCardiol.2025.5258\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Percutaneous coronary intervention (PCI) for coronary bifurcation lesions (CBLs) is a challenging procedure. The optimal stenting technique is still debated. The importance of adherence to current guideline recommendations on clinical outcomes has not yet been clarified. The authors' aim is to investigate the impact of guideline recommendations on clinical outcomes in PCI of CBL.</p><p><strong>Methods: </strong>This was a retrospective, multicenter, observational registry that enrolled patients with true CBL undergoing PCI with provisional or 2-stent techniques. All techniques were evaluated according to the current guideline recommendations. The primary endpoint of the study was target lesion failure (TLF) as a composite endpoint of target lesion revascularization (TLR), target vessel myocardial infarction (TVMI), and cardiac death.</p><p><strong>Results: </strong>A total of 1407 patients were enrolled, and the incidence of TLF, TLR, TVMI, and cardiac death were similar in provisional and 2-stent techniques. However, the incidence of TLF was higher in 2-stent (16.1%) compared to provisional (9.1%) if the guideline recommendations were not followed (HR:1.779; 95%CI: 1.187-2.668, P = .005). The incidence of TLF was lower in 2-stent (4.7%) compared to provisional (9.1%) if the guideline recommendations were followed (HR:0.501; 95% CI: 0.306-0.821, P = .005), mainly driven by reduced TLR (8.1% vs. 3.4%) (HR: 0.398; 95% CI: 0.228-0.696, P = .001) and TVMI (4.5% vs. 2.4%) (HR: 0.503; 95% CI: 0.250-1.011, P = .049).</p><p><strong>Conclusion: </strong>Adherence to current guideline recommendations is the main determinant of clinical outcomes in the PCI of CBLs rather than the selected techniques.</p>\",\"PeriodicalId\":7835,\"journal\":{\"name\":\"Anatolian Journal of Cardiology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":1.5000,\"publicationDate\":\"2025-07-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Anatolian Journal of Cardiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.14744/AnatolJCardiol.2025.5258\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Anatolian Journal of Cardiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.14744/AnatolJCardiol.2025.5258","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
摘要
背景：经皮冠状动脉介入治疗冠状动脉分叉病变（CBLs）是一项具有挑战性的手术。最佳支架置入技术仍有争议。遵守现行指南建议对临床结果的重要性尚未明确。作者的目的是调查指南建议对CBL PCI临床结果的影响。方法：这是一项回顾性、多中心、观察性登记，纳入了接受临时或双支架技术PCI治疗的真CBL患者。所有技术均根据现行指南建议进行评估。该研究的主要终点是靶病变失败（TLF），作为靶病变血运重建术（TLR）、靶血管心肌梗死（TVMI）和心源性死亡的复合终点。结果：共纳入1407例患者，临时支架和双支架技术中TLF、TLR、TVMI和心脏死亡的发生率相似。然而，如果不遵循指南建议，2支架组TLF的发生率（16.1%）高于临时组（9.1%）(HR:1.779；95%ci: 1.187-2.668, p = 0.005)。如果遵循指南建议，2支架组TLF的发生率（4.7%）低于临时组（9.1%）(HR:0.501；95% CI: 0.306-0.821, P = 0.005)，主要由TLR降低所致（8.1% vs. 3.4%） (HR: 0.398；95% CI: 0.228-0.696, P = .001)和TVMI (4.5% vs. 2.4%) (HR: 0.503；95% ci: 0.250-1.011, p = 0.049)。结论：依从目前的指南建议是CBLs PCI临床结果的主要决定因素，而不是选择的技术。
Adherence to Guideline Recommendations and Clinical Outcomes of Different Stenting Techniques in Non-Left Main Bifurcation Lesions.
Background: Percutaneous coronary intervention (PCI) for coronary bifurcation lesions (CBLs) is a challenging procedure. The optimal stenting technique is still debated. The importance of adherence to current guideline recommendations on clinical outcomes has not yet been clarified. The authors' aim is to investigate the impact of guideline recommendations on clinical outcomes in PCI of CBL.
Methods: This was a retrospective, multicenter, observational registry that enrolled patients with true CBL undergoing PCI with provisional or 2-stent techniques. All techniques were evaluated according to the current guideline recommendations. The primary endpoint of the study was target lesion failure (TLF) as a composite endpoint of target lesion revascularization (TLR), target vessel myocardial infarction (TVMI), and cardiac death.
Results: A total of 1407 patients were enrolled, and the incidence of TLF, TLR, TVMI, and cardiac death were similar in provisional and 2-stent techniques. However, the incidence of TLF was higher in 2-stent (16.1%) compared to provisional (9.1%) if the guideline recommendations were not followed (HR:1.779; 95%CI: 1.187-2.668, P = .005). The incidence of TLF was lower in 2-stent (4.7%) compared to provisional (9.1%) if the guideline recommendations were followed (HR:0.501; 95% CI: 0.306-0.821, P = .005), mainly driven by reduced TLR (8.1% vs. 3.4%) (HR: 0.398; 95% CI: 0.228-0.696, P = .001) and TVMI (4.5% vs. 2.4%) (HR: 0.503; 95% CI: 0.250-1.011, P = .049).
Conclusion: Adherence to current guideline recommendations is the main determinant of clinical outcomes in the PCI of CBLs rather than the selected techniques.
期刊介绍：
The Anatolian Journal of Cardiology is an international monthly periodical on cardiology published on independent, unbiased, double-blinded and peer-review principles. The journal’s publication language is English.
The Anatolian Journal of Cardiology aims to publish qualified and original clinical, experimental and basic research on cardiology at the international level. The journal’s scope also covers editorial comments, reviews of innovations in medical education and practice, case reports, original images, scientific letters, educational articles, letters to the editor, articles on publication ethics, diagnostic puzzles, and issues in social cardiology.
The target readership includes academic members, specialists, residents, and general practitioners working in the fields of adult cardiology, pediatric cardiology, cardiovascular surgery and internal medicine.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
