Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice

The COBIS (coronary bifurcation stenting) registry

Hyeon Cheol Gwon, Seung Hyuk Choi, Young Bin Song, Joo Yong Hahn, Myung Ho Jeong, In Whan Seong, Hyo Soo Kim, Seung-Woon Rha, Ju Young Yang, Jung Han Yoon, Seung Jea Tahk, Ki Bae Seung, Yangsoo Jang, Seung Jung Park

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2% of lesions and 82.7% of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9%, myocardial infarction (MI) in 1.2%, target lesion revascularization (TLR) in 4.7% and stent thrombosis in 0.7% of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1% vs 7.5%, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95%CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95%CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.

Original languageEnglish
Pages (from-to)2322-2328
Number of pages7
JournalCirculation Journal
Volume74
Issue number11
DOIs
Publication statusPublished - 2010 Nov 1

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Drug-Eluting Stents
Stents
Registries
Confidence Intervals
Myocardial Infarction
Korea
Paclitaxel
Thrombosis

Keywords

  • Bifurcation
  • Drug-eluting stents
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice : The COBIS (coronary bifurcation stenting) registry. / Gwon, Hyeon Cheol; Choi, Seung Hyuk; Song, Young Bin; Hahn, Joo Yong; Jeong, Myung Ho; Seong, In Whan; Kim, Hyo Soo; Rha, Seung-Woon; Yang, Ju Young; Yoon, Jung Han; Tahk, Seung Jea; Seung, Ki Bae; Jang, Yangsoo; Park, Seung Jung.

In: Circulation Journal, Vol. 74, No. 11, 01.11.2010, p. 2322-2328.

Research output: Contribution to journalArticle

Gwon, Hyeon Cheol ; Choi, Seung Hyuk ; Song, Young Bin ; Hahn, Joo Yong ; Jeong, Myung Ho ; Seong, In Whan ; Kim, Hyo Soo ; Rha, Seung-Woon ; Yang, Ju Young ; Yoon, Jung Han ; Tahk, Seung Jea ; Seung, Ki Bae ; Jang, Yangsoo ; Park, Seung Jung. / Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice : The COBIS (coronary bifurcation stenting) registry. In: Circulation Journal. 2010 ; Vol. 74, No. 11. pp. 2322-2328.
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abstract = "Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2{\%} of lesions and 82.7{\%} of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9{\%}, myocardial infarction (MI) in 1.2{\%}, target lesion revascularization (TLR) in 4.7{\%} and stent thrombosis in 0.7{\%} of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1{\%} vs 7.5{\%}, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95{\%} confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95{\%}CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95{\%}CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.",
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T1 - Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice

T2 - The COBIS (coronary bifurcation stenting) registry

AU - Gwon, Hyeon Cheol

AU - Choi, Seung Hyuk

AU - Song, Young Bin

AU - Hahn, Joo Yong

AU - Jeong, Myung Ho

AU - Seong, In Whan

AU - Kim, Hyo Soo

AU - Rha, Seung-Woon

AU - Yang, Ju Young

AU - Yoon, Jung Han

AU - Tahk, Seung Jea

AU - Seung, Ki Bae

AU - Jang, Yangsoo

AU - Park, Seung Jung

PY - 2010/11/1

Y1 - 2010/11/1

N2 - Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2% of lesions and 82.7% of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9%, myocardial infarction (MI) in 1.2%, target lesion revascularization (TLR) in 4.7% and stent thrombosis in 0.7% of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1% vs 7.5%, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95%CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95%CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.

AB - Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2% of lesions and 82.7% of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9%, myocardial infarction (MI) in 1.2%, target lesion revascularization (TLR) in 4.7% and stent thrombosis in 0.7% of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1% vs 7.5%, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95%CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95%CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.

KW - Bifurcation

KW - Drug-eluting stents

KW - Percutaneous coronary intervention

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