Sirolimus- Versus Paclitaxel-Eluting Stents for the Treatment of Coronary Bifurcations. Results From the COBIS (Coronary Bifurcation Stenting) Registry

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

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Abstract

Objectives: We aimed to compare the long-term clinical outcomes of patients treated with sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) for coronary bifurcation lesions. Background: There are limited data regarding comparisons of SES and PES for the treatment of bifurcation lesions. Methods: Patients who received percutaneous coronary intervention for non-left main bifurcation lesions were enrolled from 16 centers in Korea between January 2004 and June 2006. We compared major adverse cardiac events (MACE [cardiac death, myocardial infarction, or target lesion revascularization]) between the SES and PES groups in patients overall and in 407 patient pairs generated by propensity-score matching. Results: We evaluated 1,033 patients with bifurcation lesions treated with SES and 562 patients treated with PES. The median follow-up duration was 22 months. Treatment with SES was associated with a lower incidence of MACE (hazard ratio [HR]: 0.53, 95% confidence interval [CI]: 0.32 to 0.89, p < 0.01) and target lesion revascularization (HR: 0.55, 95% CI: 0.31 to 0.97, p = 0.02), but not of cardiac death (HR: 2.77, 95% CI: 0.40 to 18.99, p = 0.62) and cardiac death or myocardial infarction (HR: 0.97, 95% CI: 0.38 to 2.49, p = 0.94). After propensity-score matching, patients with SES still had fewer MACE and target lesion revascularization incidences than did patients with PES (HR: 0.52, 95% CI: 0.30 to 0.91, p = 0.02, and HR: 0.48, 95% CI: 0.25 to 0.91, p = 0.02, respectively). There was no significant difference in the occurrences of stent thrombosis between the groups (0.7% vs. 0.7%, p = 0.94). Conclusions: In patients with bifurcation lesions, the use of SES resulted in better long-term outcomes than did the use of PES, primarily by decreasing the rate of repeat revascularization. (Coronary Bifurcation Stenting Registry in South Korea [COBIS]; NCT00851526).

Original languageEnglish
Pages (from-to)1743-1750
Number of pages8
JournalJournal of the American College of Cardiology
Volume55
Issue number16
DOIs
Publication statusPublished - 2010 Apr 20

Keywords

  • angioplasty
  • bifurcation lesions
  • paclitaxel-eluting stent
  • sirolimus-eluting stent

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Song, Y. B., Hahn, J. Y., Choi, S. H., Choi, J. H., Lee, S. H., Jeong, M. H., Kim, H. S., Seong, I. W., Yang, J. Y., Rha, S. W., Jang, Y., Yoon, J. H., Tahk, S. J., Seung, K. B., Park, S. J., & Gwon, H. C. (2010). Sirolimus- Versus Paclitaxel-Eluting Stents for the Treatment of Coronary Bifurcations. Results From the COBIS (Coronary Bifurcation Stenting) Registry. Journal of the American College of Cardiology, 55(16), 1743-1750. https://doi.org/10.1016/j.jacc.2010.02.008