Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry

Taek Kyu Park, Yong Hwan Park, Young Bin Song, Ju Hyeon Oh, Woo Jung Chun, Gu Hyun Kang, Woo Jin Jang, Joo Yong Hahn, Jeong Hoon Yang, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Myung Ho Jeong, Hyo Soo Kim, Jae Hwan Lee, Cheol Woong Yu, Seung-Woon Rha, Yangsoo Jang, Jung Han Yoon, Seung Jea TahkKi Bae Seung, Jong Seon Park, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

12 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)1954-1962
Number of pages9
JournalCirculation Journal
Volume79
Issue number9
DOIs
Publication statusPublished - 2015 Aug 25

Fingerprint

Stents
Registries
Myocardial Infarction
Percutaneous Coronary Intervention

Keywords

  • Angioplasty
  • Medina classification
  • True bifurcation lesion

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry. / Park, Taek Kyu; Park, Yong Hwan; Song, Young Bin; Oh, Ju Hyeon; Chun, Woo Jung; Kang, Gu Hyun; Jang, Woo Jin; 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; Park, Jong Seon; Gwon, Hyeon Cheol.

In: Circulation Journal, Vol. 79, No. 9, 25.08.2015, p. 1954-1962.

Research output: Contribution to journalArticle

Park, TK, Park, YH, Song, YB, Oh, JH, Chun, WJ, Kang, GH, Jang, WJ, Hahn, JY, Yang, JH, Choi, SH, Choi, JH, Lee, SH, Jeong, MH, Kim, HS, Lee, JH, Yu, CW, Rha, S-W, Jang, Y, Yoon, JH, Tahk, SJ, Seung, KB, Park, JS & Gwon, HC 2015, 'Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry', Circulation Journal, vol. 79, no. 9, pp. 1954-1962. https://doi.org/10.1253/circj.CJ-15-0264
Park, Taek Kyu ; Park, Yong Hwan ; Song, Young Bin ; Oh, Ju Hyeon ; Chun, Woo Jung ; Kang, Gu Hyun ; Jang, Woo Jin ; 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 ; Park, Jong Seon ; Gwon, Hyeon Cheol. / Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry. In: Circulation Journal. 2015 ; Vol. 79, No. 9. pp. 1954-1962.
@article{f91ea43f18ac433bbd6ceeffe7bad680,
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",
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.",
keywords = "Angioplasty, Medina classification, True bifurcation lesion",
author = "Park, {Taek Kyu} and Park, {Yong Hwan} and Song, {Young Bin} and Oh, {Ju Hyeon} and Chun, {Woo Jung} and Kang, {Gu Hyun} and Jang, {Woo Jin} and Hahn, {Joo Yong} and Yang, {Jeong Hoon} and Choi, {Seung Hyuk} and Choi, {Jin Ho} and Lee, {Sang Hoon} and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Lee, {Jae Hwan} and Yu, {Cheol Woong} and Seung-Woon Rha and Yangsoo Jang and Yoon, {Jung Han} and Tahk, {Seung Jea} and Seung, {Ki Bae} and Park, {Jong Seon} and Gwon, {Hyeon Cheol}",
year = "2015",
month = "8",
day = "25",
doi = "10.1253/circj.CJ-15-0264",
language = "English",
volume = "79",
pages = "1954--1962",
journal = "Circulation Journal",
issn = "1346-9843",
publisher = "Japanese Circulation Society",
number = "9",

}

TY - JOUR

T1 - Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry

AU - Park, Taek Kyu

AU - Park, Yong Hwan

AU - Song, Young Bin

AU - Oh, Ju Hyeon

AU - Chun, Woo Jung

AU - Kang, Gu Hyun

AU - Jang, Woo Jin

AU - Hahn, Joo Yong

AU - Yang, Jeong Hoon

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Lee, Sang Hoon

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Lee, Jae Hwan

AU - Yu, Cheol Woong

AU - Rha, Seung-Woon

AU - Jang, Yangsoo

AU - Yoon, Jung Han

AU - Tahk, Seung Jea

AU - Seung, Ki Bae

AU - Park, Jong Seon

AU - Gwon, Hyeon Cheol

PY - 2015/8/25

Y1 - 2015/8/25

N2 - 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.

AB - 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.

KW - Angioplasty

KW - Medina classification

KW - True bifurcation lesion

UR - http://www.scopus.com/inward/record.url?scp=84940047943&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84940047943&partnerID=8YFLogxK

U2 - 10.1253/circj.CJ-15-0264

DO - 10.1253/circj.CJ-15-0264

M3 - Article

C2 - 26134457

AN - SCOPUS:84940047943

VL - 79

SP - 1954

EP - 1962

JO - Circulation Journal

JF - Circulation Journal

SN - 1346-9843

IS - 9

ER -