Coronary disease & ACSCohort study
Left main bifurcation stenting: impact of residual ischaemia on cardiovascular mortality
- Retrospective cohort study
- single-centre
- consecutive patients
Authors' conclusion
After angiographically successful LM bifurcation PCI, residual ischemia assessed by μQFR was identified in 13.2% of patients and was associated with higher risk of 3-year cardiovascular death, indicating the superior prognostic value of post-PCI physiological assessment.
Study context
- Population
- Consecutive patients undergoing left main (LM) bifurcation stenting at a large tertiary care centre, 2014–2016, with analysable post-PCI μQFR
- Participants
- 1,170 patients
- Exposure
- Residual ischaemia vs no residual ischaemia
- Residual ischemian = 155
- Outcome
- CV death
- Follow-up
- 3 years
Main finding
As reported in the abstract
Adjusted hazard ratio
3.20
95% CI 1.16–8.80
By group
Residual ischemia vs No residual ischemia
adjusted HR 3.20 (95% CI 1.16–8.80)
Observational data: associations, not effects.
Secondary outcomes
| Outcome | Residual ischemia | No residual ischemia | Estimate | |
|---|---|---|---|---|
| BOCE (major secondary) · 3 years | 17.8% | 5.8% | adjusted HR 2.79 (95% CI 1.68–4.64) | |
| CV death or target bifurcation-related MI · 3 years | 14.0% | 3.3% | adjusted HR 4.06 (95% CI 2.22–7.42) | |
| Continuous post-PCI μQFR (per 0.1 decrease) — per 0.1 μQFR decrease · CV death | HR 1.27 (95% CI 1.00–1.62) | |||
| Continuous post-PCI μQFR (per 0.1 decrease) — per 0.1 μQFR decrease · BOCE | HR 1.29 (95% CI 1.14–1.47) | |||
| 0.10.31310Ratio (log scale) |
| Outcome | Residual ischemia | No residual ischemia | Estimate |
|---|---|---|---|
| Prevalence of residual ischaemia in LAD or LCX | 13.2% | Not reported in the abstract |
Original publication
Left main bifurcation stenting: impact of residual ischaemia on cardiovascular mortality. Eur Heart J. Published 16 May 2023. doi:10.1093/eurheartj/ehad318
Summarised from the published abstract; every number is checked against it