ISSN 1016-5169 | E-ISSN 1308-4488
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Prognostic Impact of New-Onset Atrial Fibrillation After Single or Double Stent Left Main Bifurcation PC [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2022; 50(4): 256-263 | DOI: 10.5543/tkda.2022.21203

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

Gianluca Rigatelli1, Marco Zuin2, Claudio Picariello3, Filippo Gianese1, Gianni Pastore4, Enrico Baracca4, Francesco Zanon4, Loris Roncon3
1Cardiovascular Diagnosis and Endoluminal Interventions, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy
2Department of Translational Medicine, Section of Internal and CardioRespiratory Medicine, University of Ferrara, Ferrara, Italy
3Division of Cardiology, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy
4Unit of Interventional Electrophysiology, Division of Cardiology, Department of Specialistic Medicine, Rovigo General Hospital, Rovigo, Italy


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 mortality 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 techniques compared to the others. Single stent strategy had a lower risk of new-onset atrial fibrillation 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 percutaneous coronary intervention had a low incidence but resulted more frequently after double than after single stenting technique and was associated with worse outcomes.

Keywords: Left main, bifurcation stenting, atrial fibrillation, complex bifurcation

How to cite this article
Gianluca Rigatelli, Marco Zuin, Claudio Picariello, Filippo Gianese, Gianni Pastore, Enrico Baracca, Francesco Zanon, Loris Roncon. Prognostic Impact of New-Onset Atrial Fibrillation After Single or Double Stent Left Main Bifurcation PC. Turk Kardiyol Dern Ars. 2022; 50(4): 256-263

Corresponding Author: Gianluca Rigatelli
Manuscript Language: English


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