Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification - Results From the COBIS (COronary BIfurcation Stent) II Registry

Title
Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification - Results From the COBIS (COronary BIfurcation Stent) II Registry
Author(s)
박종선박택규[박택규]박용환[박용환]송영빈[송영빈]오주현[오주현]천우정[천우정]강구현[강구현]장우진[장우진]한주영[한주영]양정훈[양정훈]최승혁[최승혁]최진호[최진호]이상훈[이상훈]정명호[정명호]김효수[김효수]이재환[이재환]유철웅[유철웅]나승운[나승운]장양수[장양수]윤정한[윤정한]탁승제[탁승제]승기배[승기배]권현철[권현철]
Keywords
DRUG-ELUTING STENTS; REAL-WORLD PRACTICE; ARTERY BIFURCATION; BRANCH; IMPACT; IMPLANTATION; METAANALYSIS; PREDICTORS; STRATEGY; INSIGHTS
Issue Date
201509
Publisher
JAPANESE CIRCULATION SOC
Citation
CIRCULATION JOURNAL, v.79, no.9, pp.1954 - U282
Abstract
Background: Little is known about the clinical outcomes of patients with different types of coronary bifurcation lesions. We sought to compare long-term clinical outcomes of patients with true or non-true bifurcation lesions who underwent percutaneous coronary intervention. Methods and Results: We compared major adverse cardiac events (MACE: cardiac death, myocardial infarction [MI], or target lesion revascularization) between 1,502 patients with true bifurcation lesions (51.8%) and 1,395 with non-true bifurcation lesions (48.2%). True bifurcation lesions were defined as Medina classification (1.1.1), (1.0.1), or (0.1.1) lesions. During a median follow-up of 36 months, MACE occurred in 296 (10.2%) patients. Patients with true bifurcation lesions had a significantly higher risk of MACE than those with non-true bifurcation lesions (HR 1.39; 95% CI 1.08-1.80; P= 0.01). Among true bifurcation lesions, Medina (1.1.1) and (0.1.1) were associated with a higher risk of cardiac death or MI than Medina (1.0.1) (HR 4.15; 95% CI 1.01-17.1; P= 0.05). During the procedure, side branch occlusion occurred more frequently in Medina (1.1.1) and (1.0.1) than Medina (0.1.1) lesions (11.5% vs. 7.4%, P= 0.03). Conclusions: Patients with true bifurcation lesions had worse clinical outcomes than those with non-true bifurcation lesions. Procedural and long-term clinical outcomes differed according to the type of bifurcation lesion. These findings should be considered in future bifurcation studies.
URI
http://hdl.handle.net/YU.REPOSITORY/30970http://dx.doi.org/10.1253/circj.CJ-15-0264
ISSN
1346-9843
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의과대학 > 내과학교실 > Articles
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