Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: results from the COBIS registry
- Authors
- Gwon, Hyeon-Cheol; Hahn, Joo-Yong; Koo, Bon-Kwon; Song, Young Bin; Choi, Seung-Hyuk; Choi, Jin-Ho; Lee, Sang Hoon; Jeong, Myung-Ho; Kim, Hyo-Soo; Seong, In-Whan; Yang, Ju-Young; Rha, Seung Woon; Jang, Yangsoo; Yoon, Jung Han; Tahk, Seung-Jea; Seung, Ki Bae; Park, Seung-Jung
- Issue Date
- 2월-2012
- Publisher
- B M J PUBLISHING GROUP
- Citation
- HEART, v.98, no.3, pp.225 - 231
- Indexed
- SCIE
SCOPUS
- Journal Title
- HEART
- Volume
- 98
- Number
- 3
- Start Page
- 225
- End Page
- 231
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/106191
- DOI
- 10.1136/heartjnl-2011-300322
- ISSN
- 1355-6037
- Abstract
- Background Whether final kissing ballooning (FKB) is mandatory in the 1-stent technique is uncertain. Objective To evaluate the effect of FKB on long-term clinical outcomes in coronary bifurcation lesions treated with the 1-stent technique. Methods Consecutive patients undergoing percutaneous coronary intervention using drug-eluting stents for non-left main bifurcation lesions were enrolled from 16 centres in Korea between January 2004 and June 2006. In patients treated with the 1-stent technique major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), or target lesion revascularisation (TLR)) were compared between those undergoing main vessel stenting only (non-FKB group, n=736) or those undergoing FKB after main vessel stenting (FKB group, n=329). Propensity score-matching analysis was also performed in 222 patient pairs (444 from the non-FKB group and 222 from the FKB group). Results During follow-up (median 22 months), the FKB group had a higher incidence of MACE (HR 2.58; 95% CI 1.52 to 4.37; p<0.001) and TLR (HR 3.63; 95% CI 2.00 to 6.56; p<0.001), but not of cardiac death or MI. Most TLR occurred in the main vessel (HR 3.39 for the FKB group; 95% CI 1.86 to 6.19; p<0.001). The rate of stent thrombosis was similar in both groups (0.5% in the non-FKB group vs 0.6% in the FKB group, p=0.99). After propensity score matching, the FKB group still had higher rates of MACE and TLR than the non-FKB group (HR 2.13; 95% CI 1.15 to 3.95; p=0.02 and HR 2.84; 95% CI 1.45 to 5.55; p=0.002, respectively). Conclusions In patients treated with the 1-stent technique for bifurcation lesions, FKB after main vessel stenting may be harmful mainly due to increased TLR.
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