Impact of bifurcated lesions on prognosis of emergency percutaneous coronary intervention in patients with acute myocardial infarction

AIM:To investigate the impact of bifurcated lesions on the short-term prognosis after percutaneous coronary intervention (PCI) in patients with ST segment elevation acute myocardial infarction (AMI). METHODS: A total of 318 consecutive AMI patients treated with primary PCI within 12 h of symptom onset were divided into bifurcated group (n=92) and non-bifurcated group (n=226) based on the cineangiogram performed during PCI. RESULTS: Bifurcated lesions on angiography were found in 28.9% of the patients and predominantly involved the left anterior descending artery. In the bifurcated group, double guidewire protection, one stent plus “kissing balloon” techniques and provisional T-stenting were used, respectively, in 46%, 36% and 10% of the patients. The procedural success rate was 86% for the main artery bifurcation compared with 84% for the nonbifurcated lesion (P=0.89). No significant difference was observed in the 30-day major adverse event rates between groups (6% of bifurcated group vs. 7% of non-bifurcated group, P=0.86). CONCLUSION: In patients with ST segment elevation, AMI, immediate and short-term prognoses of PCI are similar for bifurcated and nonbifurcated lesion.