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Comparison of the planned one‐ and elective two‐stent techniques in patients with coronary bifurcation lesions with or without acute coronary syndrome from the COBIS II Registry
Author(s) -
Kim Min Chul,
Ahn Youngkeun,
Sun Sim Doo,
Joon Hong Young,
Han Kim Ju,
Ho Jeong Myung,
Gwon HyeonCheol,
Kim HyoSoo,
Rha Seung Woon,
Yoon Jung Han,
Jang Yangsoo,
Tahk SeungJea,
Seung Ki Bae
Publication year - 2018
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.27551
Subject(s) - medicine , acute coronary syndrome , cardiology , stent , coronary stent , myocardial infarction , restenosis
Objectives To evaluate the impacts of stent techniques on long‐term clinical outcomes after percutaneous coronary intervention (PCI) using drug‐eluting stents (DES) for coronary bifurcation lesions in patients with or without acute coronary syndrome (ACS). Background Few studies have investigated the impacts of stent techniques for treating coronary bifurcation lesions in patients with and without ACS. Methods This multicenter registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions. We investigated the impacts of planned one‐stent and elective two‐stent techniques in patients with ( n = 1,798) and those without ( n = 1,099) ACS. Primary endpoint was the incidence of 3‐year target‐lesion failure (TLF), defined as a composite of cardiac death, spontaneous myocardial infarction, and target‐lesion revascularization. Results The planned one‐stent technique reduced TLF rate compared to elective two‐stent technique in the ACS cohort (hazard ratio [HR] 0.49; 95% confidence interval [CI] 0.34–0.74; P = 0.001), and not in the non‐ACS cohort (HR 0.61; 95% CI 0.35–1.06; P = 0.079). After propensity score matching, the planned one‐stent technique had a significantly lower TLF rate (HR 0.47; 95% CI 0.29–0.74; P = 0.001) in patients with ACS, and it also showed a trend toward lower TLF rate with the planned one‐stent technique in patients without ACS (9.0 vs. 14.5%, HR 0.59; 95% CI 0.32–1.14; P = 0.116). Conclusions Planned one‐stenting reduced TLF in patients with ACS and it also might be beneficial in those without ACS for the treatment of coronary bifurcation lesions.