P4396Outcomes of patients with bifurcation lesions undergoing provisional 1-stent treatment - analysis from the BIONICS trial
Bibliographic record
Abstract
Introduction: Bifurcation lesions are technically challenging to treat and have been associated with an increased risk of restenosis and adverse events. The BIONICS trial was a large, multicenter randomized study comparing ridaforolimus-eluting stents (RES) with zotarolimus-eluting stents (ZES) in patients undergoing PCI. Enrollment of bifurcation lesions treated with a provisional 1-stent technique was allowed. Purpose: We sought to evaluate the clinical and angiographic outcomes of patients undergoing bifurcation lesion treatment in the BIONICS trial. Methods: A total of 1914 patients were randomized to treatment with RES or ZES and were included in the present analysis. Bifurcation lesions were analyzed by an angiographic core laboratory blinded to treatment assignment. Outcomes were analyzed according to the presence of a bifurcation lesion. Results: Baseline clinical characteristics were similar for patients with (n=686; 35.8%) and without (n=1228; 64.2%) bifurcation lesions. Among the 686 patients with bifurcation lesions, any side branch treatment was performed in 168 (24.4%) patients, with stent placement as bailout in 2 (0.3%) cases. Procedural success was high overall, and similar between patients with and without bifurcation lesions (96.8% vs 97.8%, p=0.18, respectively), with a trend toward more periprocedural MIs in the bifurcation lesion group (3.4% vs 2.2%, p=0.13). At 1 and 2 years of follow-up, there was no difference in the rate of target lesion failure (TLF) between the bifurcation and non- bifurcation groups (5.7% vs 5.1% respectively at 1 year, p=0.44, and 7.6% vs 7.3% respectively at 2 years, p=0.81). Among 195 patients with angiographic follow-up at 13 months, the main branch in-stent diameter stenosis (%) (20.1±16.5 vs 18.9±15.3, p=0.62) and rate of binary restenosis (7.9% vs 8.4%, p=0.90) were also similar between the bifurcation and non-bifurcation groups, respectively. The primary endpoint of 1-year TLF was similar with ZES and RES, and consistent in patients with and without bifurcation lesions (p interaction =0.52)
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".