The following is a summary of “Percutaneous coronary intervention of the left main coronary artery bifurcation: Insights from the PROGRESS-BIFURCATION registry,” published in the December 2024 issue of Cardiology by Carvalho et al.   

Researchers conducted a prospective study examining the outcomes of percutaneous coronary intervention (PCI) in people with and without left main coronary artery (LM) bifurcation lesions.  

They conducted the study at 6 centers in the United States, Russia, and Turkey (2013 and 2024_ as part of the Prospective Global Registry of Percutaneous Coronary Intervention in Bifurcation Lesions (PROGRESS-BIFURCATION). Procedural characteristics and follow-up outcomes were assessed for people with LM and non-LM bifurcation lesions, using mixed effects Cox regression to calculate multivariable-adjusted hazard ratios (aHR) with 95% CI.  

The results showed 1,171 people who underwent bifurcation PCI, and 308 (26.3%) had LM bifurcation PCI. People in the LM group were older (76.3 ± 11.0 vs. 65.5 ± 11.5 years; P<0.001) and had more comorbidities, like diabetes, heart failure, prior PCI, and prior coronary artery bypass graft (CABG) surgery, 2-stent techniques were used more frequently in people with LM bifurcation lesions (38.7% vs. 26.2%, P<0.001). Technical success was similar between groups (95.6% vs. 94.8%, P=0.56) and procedural success (90.6% vs. 91.1%, P=0.796). Side-branch occlusion was less common in people with LM bifurcation lesions (4.0% vs. 16.9%, P<0.001). During a median follow-up of 1,095 days, people who underwent LM bifurcation PCI had higher incidences of major adverse cardiac events (MACE) (aHR 1.91; 95% CI 1.42–2.56; P<0.001) and all-cause mortality (aHR 2.29; 95% CI 1.55–3.41; P<0.001) compared with people who underwent non-LM bifurcation PCI.  

They concluded that, compared to people who underwent non-LM bifurcation PCI, those who underwent LM bifurcation PCI were older, had more comorbidities, and had higher rates of MACE and mortality during follow-up.  

Source: internationaljournalofcardiology.com/article/S0167-5273(24)01555-9/abstract