The Outcome Of Percutaneous Coronary Intervention For Sever Atherosclerostic Lesions In Segment Proximal To Myocardial Bridge At Left Anterior Descending Coronary Artery

Objective:To evaluate the efficacy of percutaneous interventional treatment for severe atherosclerosis lesions in the segments proximal to myocardial bridge at left anterior descending coronary artery(LAD).Methods:A total of 330 consecutive patients with LAD severe stenosis who were diagnosed as acute coronary syndrome(ACS) were included. According to whether combined with MB,patients were divided into MB group(MB n=48) and non-MB group(NMB n=282). Drug eluting stents was successfully implanted in the stenostic segments prior to myocardial bridge.All patients were followed up during hospital stay, 30 days and 12 months after PCI to evaluate major adverse cardiac events(MACEs).Results:1 Parts of baseline characteristics have significant difference between the two groups.2 There was no difference in the incidence of MACE between the two groups(6.2%vs2.1%, p=0.254) while in hospital. During the follow-up of 30 days and 12 months after PCI, the rate of MACE was significantly higher in the MB group than in the non-MB group(29.2%vs7.1%,p <0.001; 58.3%vs21.3%,p <0.001).3 Stent restenosis occurred in 4 patients of MB group, in 5 patients of non-MB group respectively, the rate of stent restenosis was higher in the MB group than in the non-MB group(8.3%vs1.8%, p=0.036); The incidence of stent intimal hyperplasia and stent thrombosis has no significant differences between the two groups statistically(6.2%vs1.8%;2.1%vs0.0%respectively,both p value <0.005); There were no stent fracture occurred in both two groups;4 Multivariate regression analysis showed that the presence of MB was an independent predictor for MACE(OR=1.710, 95%CI=0.767-3.815,p=0.019).Conclusions:1 The patients with severe atherosclerosis lesions in the segments proximal to myocardial bridge at LAD treated with DES have a higher incidence of MACE.2 MB appears to be associated with a higher incidence of stent restenosis after PCI.3 Myocardial bridge is a significant factor in the occurrence of major adverse cardiac events after stent implantation.