Author + information
- Received January 14, 2013
- Revision received April 1, 2013
- Accepted April 9, 2013
- Published online July 2, 2013.
- Michael Maeng, MD∗∗ (, )
- Niels R. Holm, MD∗,
- Andrejs Erglis, MD†,
- Indulis Kumsars, MD†,
- Matti Niemelä, MD‡,
- Kari Kervinen, MD‡,
- Jan S. Jensen, MD§,
- Anders Galløe, MD§,
- Terje K. Steigen, MD⋮,
- Rune Wiseth, MD¶,
- Inga Narbute, MD†,
- Pål Gunnes, MD#,
- Jan Mannsverk, MD∗∗,
- Oliver Meyerdierks, MD††,
- Svein Rotevatn, MD‡‡,
- Kjell Nikus, MD§§,
- Saila Vikman, MD§§,
- Jan Ravkilde, MD⋮⋮,
- Stefan James, MD¶¶,
- Jens Aarøe, MD⋮⋮,
- Antti Ylitalo, MD##,
- Steffen Helqvist, MD∗∗∗,
- Iwar Sjögren, MD†††,
- Per Thayssen, MD‡‡‡,
- Kari Virtanen, MD§§§,
- Mikko Puhakka, MD⋮⋮⋮,
- Juhani Airaksinen, MD¶¶¶,
- Evald H. Christiansen, MD∗,
- Jens F. Lassen, MD∗,
- Leif Thuesen, MD∗,
- Nordic-Baltic Percutaneous Coronary Intervention Study Group
- ∗Department of Cardiology, Aarhus University Hospital, Skejby, Denmark
- †Department of Cardiology, Paul Stradins Clinical Hospital, Riga, Latvia
- ‡Division of Cardiology, Oulu University Hospital, Oulu, Finland
- §Department of Cardiology, Gentofte University Hospital, Gentofte, Denmark
- ⋮Department of Cardiology, University Hospital of North Norway and Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway
- ∗∗Department of Cardiology, University Hospital of Tromsø, Tromsø, Norway
- ¶Department of Cardiology, St. Olav Hospital, Trondheim, Norway
- #Department of Cardiology, The Feiring Clinic, Feiring, Norway
- ††Department of Cardiology, Ullevaal University Hospital, Oslo, Norway
- ‡‡Department of Cardiology, Haukeland University Hospital, Bergen, Norway
- §§Department of Cardiology, Tampere University Hospital, Tampere, Finland
- ⋮⋮Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
- ¶¶Department of Cardiology, Uppsala University Hospital, Uppsala, Sweden
- ##Department of Cardiology, Satakunta Central Hospital, Pori, Finland
- ∗∗∗Department of Cardiology, Rigshospitalet, Copenhagen, Denmark
- †††Department of Cardiology, Falun Hospital, Falun, Sweden
- ‡‡‡Department of Cardiology, Odense University Hospital, Odense, Denmark
- §§§Division of Cardiology, Helsinki University Central Hospital, Helsinki, Finland
- ⋮⋮⋮Division of Cardiology, Kuopio University Central Hospital, Kuopio, Finland
- ¶¶¶Division of Cardiology, Turku University Central Hospital, Turku, Finland
- ↵∗Reprint requests and correspondence:
Dr. Michael Maeng, Department of Cardiology, Aarhus University Hospital, Brendstrupgaardsvej, Skejby, 8200 Aarhus N, Denmark.
Objectives This study sought to report the 5-year follow-up results of the Nordic Bifurcation Study.
Background Randomized clinical trials with short-term follow-up have indicated that coronary bifurcation lesions may be optimally treated using the optional side branch stenting strategy.
Methods A total of 413 patients with a coronary bifurcation lesion were randomly assigned to a simple stenting strategy of main vessel (MV) and optional stenting of side branch (SB) or to a complex stenting strategy, namely, stenting of both MV and SB.
Results Five-year clinical follow-up data were available for 404 (98%) patients. The combined safety and efficacy endpoint of cardiac death, non–procedure-related myocardial infarction, and target vessel revascularization were seen in 15.8% in the optional SB stenting group as compared to 21.8% in the MV and SB stenting group (p = 0.15). All-cause death was seen in 5.9% versus 10.4% (p = 0.16) and non–procedure-related myocardial infarction in 4% versus 7.9% (p = 0.09) in the optional SB stenting group versus the MV and SB stenting group, respectively. The rates of target vessel revascularization were 13.4% versus 18.3% (p = 0.14) and the rates of definite stent thrombosis were 3% versus 1.5% (p = 0.31) in the optional SB stenting group versus the MV and SB stenting group, respectively.
Conclusions At 5-year follow-up in the Nordic Bifurcation Study, the clinical outcomes after simple optional side branch stenting remained at least equal to the more complex strategy of planned stenting of both the main vessel and the side branch.
The study was supported by an unrestricted grant from Cordis, a Johnson & Johnson company. Dr. Holm has received research grants and honoraria from Cordis; research grants, speaker's fees, and honoraria from St. Jude Medical; and speaker's fees and honoraria from Terumo. Dr. James has received research grants from Terumo, Medtronic, and Vascular Solutions. Dr. Thuesen is a physician proctor for Edwards Lifesciences Corporation. All other authors have reported they have no relationships relevant to the contents of this paper to disclose. Drs. Maeng and Holm contributed equally to this study.
- Received January 14, 2013.
- Revision received April 1, 2013.
- Accepted April 9, 2013.
- American College of Cardiology Foundation