Impact of Bifurcation Stent Technique on Clinical Outcomes in Patients with a Medina 0,0,1 Coronary Bifurcation Lesion: Results from the COBIS (COronary BIfurcation Stenting) II Registry

Abstract

ObjectiveTo compare the long-term clinical outcomes of patients treated with 1- versus 2-stent techniques for Medina 0,0,1 type bifurcation lesions. Background: Little is known about clinical outcomes and optimal treatment strategies for Medina 0,0,1 type bifurcation lesions MethodsA total of 2,897 consecutive patients who underwent percutaneous coronary intervention using a drug-eluting stent for a coronary bifurcation lesion with a side branch (SB) 2.3 mm were enrolled from 18 centers in South Korea. We compared target lesion failure (TLF), defined as the composite of cardiac death, myocardial infarction, or target lesion revascularization (TLR) according to 1- or 2-stent techniques in the patients with a de novo Medina 0,0,1 type bifurcation lesion (n=113, 3.9%) ResultsFifty patients were treated with the 1-stent technique, and 63 patients with the 2-stent technique. During a median follow-up duration of 36.6 months, patients in the 1-stent technique group tended to have a higher incidence of TLR (3.2 versus 12.0%, P=0.07) and TLF (4.8 versus 12.0%, P=0.16) than those in the 2-stent technique group. Multivariate analysis revealed that the 1-stent technique was associated with a higher risk of TLR (hazard ratio [HR] 7.35; 95% confidence interval [CI] 1.27-42.5; P=0.03) and TLF (HR 4.65; 95% CI 1.01-21.6; P=0.05) than the 2-stent technique ConclusionsIn patients with a Medina 0,0,1 type bifurcation lesion, the 2-stent technique seems to be associated with a better clinical outcome compared with the 1-stent technique. These findings need to be confirmed in randomized controlled trials. (c) 2014 Wiley Periodicals, Inc.