Author + information
- Received June 28, 2012
- Revision received October 10, 2012
- Accepted October 26, 2012
- Published online February 1, 2013.
- Alex Sirker, MB BChir, PhD⁎,
- Manav Sohal, MBBS†,
- Keith Oldroyd, MD (Hons)‡,
- Nick Curzen, BM (Hons), PhD§,
- Rod Stables, DM (Oxon), BM BCh (Oxon)∥,
- Adam de Belder, MD¶,# and
- David Hildick-Smith, MD¶,#,⁎ ()
- ↵⁎Reprint requests and correspondence:
Dr. David Hildick-Smith, Sussex Cardiac Centre, Royal Sussex County Hospital, Eastern Road, Brighton, Sussex BN2 5BE, United Kingdom
Objectives This study sought to assess the impact of coronary bifurcation stenting on health-related functional status, using the Seattle Angina Questionnaire (SAQ), for participants in the BBC ONE (British Bifurcation Coronary; Old, New, and Evolving Strategies) trial and to compare simple versus complex bifurcation stenting strategies in this regard.
Background Large randomized studies have examined outcomes from bifurcation stenting with drug-eluting stents. They have reported on major adverse cardiovascular events and angiographic follow-up. However, a principal goal of percutaneous coronary intervention is symptom control and improvement in quality of life, yet there are no published data from these trials on this aspect. Furthermore, it is unknown whether simple versus complex stenting strategies have different effects on angina control and quality of life.
Methods The BBC ONE study randomized 500 subjects to bifurcation stenting using either a simple (provisional T) or complex (crush or culotte) approach. Subjects completed the SAQ at baseline and at 9 months after percutaneous coronary intervention. Canadian Cardiovascular Society class and antianginal drug use were also evaluated.
Results Bifurcation stenting was associated with significant improvements on SAQ scales and in Canadian Cardiovascular Society class (baseline: 5.3% subjects were class 0; follow-up: 64.0% were class 0; p < 0.001) and a significant reduction in the number of antianginal drugs used (median decrease: 1; p < 0.001). Simple and complex strategies did not differ significantly for changes in the SAQ, actual SAQ scores, or use of antianginal drugs.
Conclusions Regardless of chosen strategy, bifurcation stenting produced significant functional improvements in angina-related health. No significant difference between simple and complex strategies was found in this regard.
Dr. Curzen has reported that he has received speaker's fees from Abbott Vascular, Boston Scientific, Medtronic, and St. Jude Medical, as well as research grants from St. Jude Medical, Medtronic, and Haemonetics. Dr. de Belder has reported that he has received honoraria for training and sponsorship for meetings from Boston Scientific. Dr. Hildick-Smith has reported that he has served on the advisory board of Boston Scientific. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received June 28, 2012.
- Revision received October 10, 2012.
- Accepted October 26, 2012.
- American College of Cardiology Foundation