| Objective:Interventional treatment of coronary artery bifurcation disease is difficult,and the risk of in-stent restenosis,adverse cardiovascular events and in-stent thrombosis is high.Clinically,there is no unified operation and treatment for bifurcation lesions,and there is no optimal treatment.Therefore,we designed this single-center clinical study to explore the safety and efficacy of different surgical treatments in patients with coronary artery bifurcation disease,and to analyze the risk factors affecting the prognosis of patients with coronary artery bifurcation disease.Methods:A total of 166 patients with coronary bifurcation lesions who received percutaneous coronary intervention in our hospital from January 2018 to January2021 were divided into two groups according to the type of operation(double stent group nude 92,stent+drug balloon group 74).The baseline data of the patients,the coronary angiography(including the blood vessels of the patients before and immediately after the operation)were recorded,and the major adverse cardiovascular events(MACE)within 4 years after operation were followed up for survival analysis.At the same time,the revascularization of the target lesions was followed up,and the late lumen loss of the patients could be reexamined.T-test was used to compare the measurement data of normal distribution,Mann-Whitney U test was used to compare the measurement data of non-normal distribution between groups,use case(rate)of counting data was expressed,X~2 test was used for comparison between groups,multivariate Logistic regression analysis was used to screen the influencing factors of CBL,Kaplan-Meier method was used to draw survival curve,and Logrank method was used to calculate the difference between the two groups.Results:(1)There was significant difference in VLDL and TBIL in baseline data between the two groups,but there was no significant difference in other baseline data.(2)Multivariate Logistic regression analysis showed that there was a negative correlation between patients with oral nitroglycerin and patients with bifurcation lesions,and a positive correlation between patients with age and hypertension and patients with bifurcation lesions.Hypertension would increase the incidence of MACE events in patients with double stents.(3)The incidence of angina pectoris in the double stent group was lower than that in the stent+drug balloon group(32.6%vs.18.9%MACE 0.047),but there was no significant difference in total angina pectoris between the two groups.(4)There was no significant difference in main branch angiography between the two groups(P>0.05).The lesion length,reference lumen diameter,preoperative minimum lumen diameter,stent/drug balloon diameter,stent/drug balloon length,postoperative minimum lumen diameter and postoperative minimum lumen diameter were 20.12±5.29 VS,2.23±0.44 VS,0.16±0.09,3.26±0.43 VS,22.55±5.76 VS,2.92±0.45 VS,1.99±0.31,respectively.The degree of stenosis of the minimum lumen diameter after operation(7.81±1.78 VS 11.31±1.24)was statistically significant(p<0.01).(5)The survival rate of the double-stent group was high(P<0.05).Conclusions:(1)Nitroglycerin is the protective factor of bifurcation disease,hypertension and advanced age are the risk factors of bifurcation.(2)Hypertension is positively correlated with MACE events in double stent group.(3)The incidence of angina pectoris is lower in stent+drug balloon group,but the survival rate is higher in double stent group.(4)The use of stents combined with drug balloons for the treatment of late stage lumen loss in patients with coronary bifurcation disease is not inferior to dual stent therapy. |
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