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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
Author(s) -
Jang Woo Jin,
Song Young Bin,
Hahn JooYong,
Choi SeungHyuk,
Kim HyoSoo,
Yu Cheol Woong,
Rha Seung Woon,
Jang Yangsoo,
Seung Ki Bae,
Gwon HyeonCheol
Publication year - 2014
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25495
Subject(s) - medicine , stent , target lesion , percutaneous coronary intervention , hazard ratio , lesion , myocardial infarction , cardiology , confidence interval , radiology , surgery
Objective To 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 Methods A 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%) Results Fifty 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 Conclusions In 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. © 2014 Wiley Periodicals, Inc.