Archives of the
Turkish Society of Cardiology
Original Article

Prognostic Impact of New-Onset Atrial Fibrillation After Single or Double Stent Left Main Bifurcation PCI

1.

Cardiovascular Diagnosis and Endoluminal Interventions, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy

2.

Department of Translational Medicine, Section of Internal and CardioRespiratory Medicine, University of Ferrara, Ferrara, Italy

3.

Division of Cardiology, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy

4.

Unit of Interventional Electrophysiology, Division of Cardiology, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy

Archives of the Turkish Society of Cardiology 2022; 50: 256-263
DOI: 10.5543/tkda.2022.21203
Read: 943 Downloads: 185 Published: 01 June 2022

Objective: Incidence and prognostic value of new-onset atrial fibrillation after single versus double stent strategy in bifurcation left main disease has not been yet investigated.

Methods: We retrospectively analyzed the procedural and medical data of patients referred to our center for complex left main bifurcation disease, treated using crossover provisional stenting, T or T-and-Protrusion, Culotte, and Nano-inverted-T techniques between January 1, 2008, and May 1, 2018. Multivariate Cox-regression analysis was used to assess the role of different stent strategies, adjusted for confounders, on the risk of new-onset atrial fibrillation during the follow-up period.

Results: Five hundred two patients (316 males, mean age 70.3 ± 12.8 years, mean Syntax score 31.6 ± 6.3) were evaluated. At a mean follow-up of 37.1 ± 10.8 months (range: 22.1- 39.3 months); Target lesion failure rate was 10.1%. Stent thrombosis and cardiovascular mor- tality were observed in 1.2% and 3.6% in of cases, respectively. New-onset atrial fibrillation occurred in 23 out of 502 patients (4.6%). Patients with new-onset atrial fibrillation resulted more frequently female, older, obese, and diabetic and more frequently experienced target lesion failure and cardiovascular death. New-onset atrial fibrillation-free survival favored single versus double stent technique and among double stent techniques nano-inverted-T tech- niques compared to the others. Single stent strategy had a lower risk of new-onset atrial fibril- lation compared to double stent technique on multivariate analysis (Hazard Ratio (HR): 1.14, 95% CI: 1.10-1.19, P < .001 vs. HR: 1.28, 95% CI: 1.23-1.32, P < .0001).

Conclusion: New-onset atrial fibrillation in distal left main bifurcation disease treated with per- cutaneous coronary intervention had a low incidence but resulted more frequently after double than after single stenting technique and was associated with worse outcomes.

Cite this article as: Rigatelli G, Zuin M, Picariello C, et al. Prognostic impact of new-onset atrial fibrillation after single or double stent left main bifurcation PCI. Turk Kardiyol Dern Ars 2022;50(4):256-263.

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TURKISH
ISSN 1016-5169 EISSN 1308-4488