Author + information
- Nene Ugoeke,
- Hemang Panchal,
- Yasir Taha and
- Timir Paul
Background: Stenting of bifurcation coronary lesions is challenging, associated with adverse outcomes. Prior studies have identified various predictors of long-term outcome. The goal of this study is to investigate in-hospital mortality differences in index hospitalization in patients with acute ST-elevation myocardial infarction (STEMI), who underwent stenting of bifurcation versus non-bifurcation lesions.
Methods: Using 2012 data from the National Inpatient Sample (NIS), we examined 26,414 admissions in which coronary artery stenting was performed in the setting of acute STEMI. International Classification of Diseases, Ninth Revision (ICD-9) procedure codes were used to identify procedures involving bifurcation lesions. Chi-square tests were used to assess association between percutaneous coronary bifurcation stenting and mortality during hospitalization.
Results: Of the 26,414 coronary stent placements performed in 2012 in the setting of acute STEMI, 595 involved bifurcation lesions. Of these, there were 23 in-hospital deaths – a mortality rate of 3% compared to 4.4% in patients who underwent stent placements in non-bifurcation lesions. An unadjusted analysis of bifurcation vs. non-bifurcation stenting and in-hospital mortality showed no statistically significant association (p-value= 0.53). Further stratification of by age ≥ 65, tobacco use and obesity showed no statistically significant association (p-value 0.21, 0.89 and 0.50, respectively) between in-hospital mortality and stenting in the two groups.
Conclusions: The results of this study showed there was no statistically significant difference in in-hospital mortality rates in patients who underwent stenting of coronary bifurcation lesions in acute STEMI compared to non-bifurcation lesions. With inherent limitations in database analyses, further studies are necessary to identify independent predictors of in-hospital mortality in this setting.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Complex Coronary Intervention: Left Main/Bifurcations and Multivessel Disease
Abstract Category: 22. Interventional Cardiology: Coronary Intervention: Left Main, Multivessel, Bifurcation
Presentation Number: 1157-185
- 2017 American College of Cardiology Foundation