Differential Prognostic Impact of Treatment Strategy Among Patients With Left Main Versus Non-Left Main Bifurcation Lesions Undergoing Percutaneous Coronary Intervention Results From the COBIS (Coronary Bifurcation Stenting) Registry II
- Authors
- Song, Young Bin; Hahn, Joo-Yong; Yang, Jeong Hoon; Choi, Seung-Hyuk; Choi, Jin-Ho; Lee, Sang Hoon; Jeong, Myung-Ho; Kim, Hyo-Soo; Lee, Jae-Hwan; Yu, Cheol Woong; Rha, Seung Woon; Jang, Yangsoo; Yoon, Jung Han; Tahk, Seung-Jea; Seung, Ki Bae; Oh, Ju Hyeon; Park, Jong-Seon; Gwon, Hyeon-Cheol
- Issue Date
- 3월-2014
- Publisher
- ELSEVIER SCIENCE INC
- Keywords
- angioplasty; bifurcation lesions; drug-eluting stent(s); left main
- Citation
- JACC-CARDIOVASCULAR INTERVENTIONS, v.7, no.3, pp.255 - 263
- Indexed
- SCIE
SCOPUS
- Journal Title
- JACC-CARDIOVASCULAR INTERVENTIONS
- Volume
- 7
- Number
- 3
- Start Page
- 255
- End Page
- 263
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/99068
- DOI
- 10.1016/j.jcin.2013.11.009
- ISSN
- 1936-8798
- Abstract
- Objectives The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions. Background Few studies have considered anatomic location when comparing 1- and 2-stent strategies for bifurcation lesions. Methods We compared the prognostic impact of treatment strategies on clinical outcomes in 2,044 patients with non-LM bifurcation lesions and 853 with LM bifurcation lesions. The primary outcome was target lesion failure (TLF) defined as a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization. Results The 2-stent strategy was used more frequently in the LM bifurcation group than in the non-LM bifurcation group (40.3% vs. 20.8%, p < 0.01). During a median follow-up of 36 months, the 2-stent strategy was not associated with a higher incidence of cardiac death (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 0.72 to 2.14; p = 0.44), cardiac death or MI (HR: 1.12; 95% CI: 0.58 to 2.19; p = 0.73), or TLF (HR: 1.39; 95% CI: 0.99 to 1.94; p = 0.06) in the non-LM bifurcation group. In contrast, in patients with LM bifurcation lesions, the 2-stent strategy was associated with a higher incidence of cardiac death (HR: 2.43; 95% CI: 1.05 to 5.59; p = 0.04), cardiac death or MI (HR: 2.09; 95% CI: 1.08 to 4.04; p = 0.03), as well as TLF (HR: 2.38; 95% CI: 1.60 to 3.55; p < 0.01). Significant interactions were present between treatment strategies and bifurcation lesion locations for TLF (p = 0.01). Conclusions The 1-stent strategy, if possible, should initially be considered the preferred approach for the treatment of coronary bifurcation lesions, especially LM bifurcation lesions. (Korean Coronary Bifurcation Stenting [COBIS] Registry II; NCT01642992) (C) 2014 by the American College of Cardiology Foundation
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Collections - College of Medicine > Department of Medical Science > 1. Journal Articles
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