THE IMPACT OF BIFURCATION LESIONS ON 6-MONTH ANGIOGRAPHIC AND LONG TERM CLINICAL OUTCOMES IN ACUTE MYOCARDIAL INFARCTION UNDERGOING PERCUTANEOUS CORONARY INTERVENTION WITH DRUG-ELUTING STENTS

• Ji Young Park, 
• Seung–Woon Rha, 
• Amro Elnagar, 
• Byoung Geol Choi, 
• Sung II Im, 
• Sunwon Kim, 
• Jin Oh Na,
• Seongwoo Han, 
• Cheol Ung Choi, 
• Hong Euy Lim, 
• Jin Won Kim, 
• Eung Ju Kim, 
• Hong-Seog Seo, 
• Chang Gyu Park, 
• Dong Joo Oh

• Cardiology Department, Eulji General Hospital, Seoul, South Korea, Cardiovascular Center, Korea University Guro Hospital, Seoul, South Korea

Background

Bifurcation lesions remain a challenging lesion subset, often associated with lower success rates. There are limited data regarding the angiographic and clinical outcomes of bifurcation intervention in the acute myocardial infarction (AMI) setting.

Methods

A total of 903 patients (pts) were underwent percutaneous coronary intervention (PCI) for AMI were enrolled. Study populations were divided into two groups: Bifurcation group (n= 332) and non Bifurcation group (n=571). The Mid–term angiographic and long–term clinical outcomes were evaluated between the two groups up to 2 years.

Results

The baseline clinical characteristics were similar between the two groups except male and non ST elevation myocardial infarction were higher in Bifurcation group. Peak values of troponin T, CK–MB, BNP, and LVEF were similar between the two groups. At 6 months, angiographic outcomes were similar between the two groups. At 24 months, the cumulative incidence of total death, cardiac death, Q–MI and total major adverse cardiac events (MACE) were similar between the 2 groups; however, the incidence of TLR, TVR and TVR–MACEs were higher in the bifurcation group (Table).

Conclusion

Despite being challenging lesions, bifurcations in the setting of AMI was associated with similar mid–term angiographic and long term clinical outcomes except higher incidence of repeat revascularization during 24 month follow up as compared to non bifurcation lesions.

Copyright © 2012 Published by Elsevier Inc. All rights reserved.