Estrategia de tratamiento de lesiones en bifurcación tratadas con ICP primaria en el contexto del IAMCEST. Registro COBIS II

Translated title of the contribution: Treatment Strategy for STEMI With Bifurcation Culprit Lesion Undergoing Primary PCI: The COBIS II Registry

Ki Hong Choi, Young Bin Song, Jin Ok Jeong, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Joo Yong Hahn, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Myung Ho Jeong, Bon Kwon Koo, Hyo Soo Kim, Cheol Woong Yu, Seung-Woon Rha, Yangsoo Jang, Jung Han Yoon, Ju Hyeon Oh, Jong Seon Park, Hyeon Cheol Gwon

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Introduction and objectives: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). Methods: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009. Among the registered population, 367 (12.7%) patients had STEMI; of these, a 1-stent strategy was used in 304 patients and a 2-stent strategy in 63 patients; 77.1% of the patients received primary PCI with a first-generation drug-eluting stent. The inverse-probability-of-treatment-weighting method was used to adjust for confounding factors. The primary outcome was major adverse cardiovascular events (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularization, and stent thrombosis. Results: The median length of follow-up was 38 months. Postprocedural side branch diameter stenosis differed significantly between the 2 groups (1-stent vs 2-stent, 42.7% vs 9.7%; P <.001). After the performance of inverse-probability-of-treatment-weighting methods, the rate of MACE was significantly higher in the 2-stent group than in the 1-stent group (HR, 1.85; 95%CI, 1.19-2.87; P =.006), mainly driven by target lesion revascularization and stent thrombosis. Conclusions: In STEMI patients with bifurcation culprit lesions undergoing primary PCI, the 2-stent strategy had significantly higher rates of MACE than the 1-stent strategy, despite successful treatment of the side branch. However, this result should be interpreted with caution because this study does not reflect current practice. Full English text available from: www.revespcardiol.org/en

Original languageSpanish
JournalRevista Espanola de Cardiologia
DOIs
Publication statusAccepted/In press - 2018 Jan 1

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Percutaneous Coronary Intervention
Stents
Registries
Therapeutics
Drug-Eluting Stents
ST Elevation Myocardial Infarction
Thrombosis
Pathologic Constriction
Myocardial Infarction

Keywords

  • Bifurcation lesions
  • Drug-eluting stent
  • Primary percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Estrategia de tratamiento de lesiones en bifurcación tratadas con ICP primaria en el contexto del IAMCEST. Registro COBIS II. / Choi, Ki Hong; Song, Young Bin; Jeong, Jin Ok; Park, Taek Kyu; Lee, Joo Myung; Yang, Jeong Hoon; Hahn, Joo Yong; Choi, Seung Hyuk; Choi, Jin Ho; Lee, Sang Hoon; Jeong, Myung Ho; Koo, Bon Kwon; Kim, Hyo Soo; Yu, Cheol Woong; Rha, Seung-Woon; Jang, Yangsoo; Yoon, Jung Han; Oh, Ju Hyeon; Park, Jong Seon; Gwon, Hyeon Cheol.

In: Revista Espanola de Cardiologia, 01.01.2018.

Research output: Contribution to journalArticle

Choi, KH, Song, YB, Jeong, JO, Park, TK, Lee, JM, Yang, JH, Hahn, JY, Choi, SH, Choi, JH, Lee, SH, Jeong, MH, Koo, BK, Kim, HS, Yu, CW, Rha, S-W, Jang, Y, Yoon, JH, Oh, JH, Park, JS & Gwon, HC 2018, 'Estrategia de tratamiento de lesiones en bifurcación tratadas con ICP primaria en el contexto del IAMCEST. Registro COBIS II', Revista Espanola de Cardiologia. https://doi.org/10.1016/j.recesp.2017.12.019
Choi, Ki Hong ; Song, Young Bin ; Jeong, Jin Ok ; Park, Taek Kyu ; Lee, Joo Myung ; Yang, Jeong Hoon ; Hahn, Joo Yong ; Choi, Seung Hyuk ; Choi, Jin Ho ; Lee, Sang Hoon ; Jeong, Myung Ho ; Koo, Bon Kwon ; Kim, Hyo Soo ; Yu, Cheol Woong ; Rha, Seung-Woon ; Jang, Yangsoo ; Yoon, Jung Han ; Oh, Ju Hyeon ; Park, Jong Seon ; Gwon, Hyeon Cheol. / Estrategia de tratamiento de lesiones en bifurcación tratadas con ICP primaria en el contexto del IAMCEST. Registro COBIS II. In: Revista Espanola de Cardiologia. 2018.
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abstract = "Introduction and objectives: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). Methods: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009. Among the registered population, 367 (12.7{\%}) patients had STEMI; of these, a 1-stent strategy was used in 304 patients and a 2-stent strategy in 63 patients; 77.1{\%} of the patients received primary PCI with a first-generation drug-eluting stent. The inverse-probability-of-treatment-weighting method was used to adjust for confounding factors. The primary outcome was major adverse cardiovascular events (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularization, and stent thrombosis. Results: The median length of follow-up was 38 months. Postprocedural side branch diameter stenosis differed significantly between the 2 groups (1-stent vs 2-stent, 42.7{\%} vs 9.7{\%}; P <.001). After the performance of inverse-probability-of-treatment-weighting methods, the rate of MACE was significantly higher in the 2-stent group than in the 1-stent group (HR, 1.85; 95{\%}CI, 1.19-2.87; P =.006), mainly driven by target lesion revascularization and stent thrombosis. Conclusions: In STEMI patients with bifurcation culprit lesions undergoing primary PCI, the 2-stent strategy had significantly higher rates of MACE than the 1-stent strategy, despite successful treatment of the side branch. However, this result should be interpreted with caution because this study does not reflect current practice. Full English text available from: www.revespcardiol.org/en",
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T1 - Estrategia de tratamiento de lesiones en bifurcación tratadas con ICP primaria en el contexto del IAMCEST. Registro COBIS II

AU - Choi, Ki Hong

AU - Song, Young Bin

AU - Jeong, Jin Ok

AU - Park, Taek Kyu

AU - Lee, Joo Myung

AU - Yang, Jeong Hoon

AU - Hahn, Joo Yong

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Lee, Sang Hoon

AU - Jeong, Myung Ho

AU - Koo, Bon Kwon

AU - Kim, Hyo Soo

AU - Yu, Cheol Woong

AU - Rha, Seung-Woon

AU - Jang, Yangsoo

AU - Yoon, Jung Han

AU - Oh, Ju Hyeon

AU - Park, Jong Seon

AU - Gwon, Hyeon Cheol

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Introduction and objectives: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). Methods: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009. Among the registered population, 367 (12.7%) patients had STEMI; of these, a 1-stent strategy was used in 304 patients and a 2-stent strategy in 63 patients; 77.1% of the patients received primary PCI with a first-generation drug-eluting stent. The inverse-probability-of-treatment-weighting method was used to adjust for confounding factors. The primary outcome was major adverse cardiovascular events (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularization, and stent thrombosis. Results: The median length of follow-up was 38 months. Postprocedural side branch diameter stenosis differed significantly between the 2 groups (1-stent vs 2-stent, 42.7% vs 9.7%; P <.001). After the performance of inverse-probability-of-treatment-weighting methods, the rate of MACE was significantly higher in the 2-stent group than in the 1-stent group (HR, 1.85; 95%CI, 1.19-2.87; P =.006), mainly driven by target lesion revascularization and stent thrombosis. Conclusions: In STEMI patients with bifurcation culprit lesions undergoing primary PCI, the 2-stent strategy had significantly higher rates of MACE than the 1-stent strategy, despite successful treatment of the side branch. However, this result should be interpreted with caution because this study does not reflect current practice. Full English text available from: www.revespcardiol.org/en

AB - Introduction and objectives: There are limited data on the preferred treatment strategy in ST-segment elevation myocardial infarction (STEMI) patients with bifurcation lesions. This study aimed to compare clinical outcomes between 1-stent and 2-stent strategies in STEMI patients with bifurcation lesions undergoing primary percutaneous coronary intervention (PCI). Methods: The COronary BIfurcation Stenting II is a retrospective multicenter registry of 2897 consecutive patients with bifurcation lesions undergoing PCI with drug-eluting stents from January 2003 through December 2009. Among the registered population, 367 (12.7%) patients had STEMI; of these, a 1-stent strategy was used in 304 patients and a 2-stent strategy in 63 patients; 77.1% of the patients received primary PCI with a first-generation drug-eluting stent. The inverse-probability-of-treatment-weighting method was used to adjust for confounding factors. The primary outcome was major adverse cardiovascular events (MACE), a composite of cardiac death, myocardial infarction, target lesion revascularization, and stent thrombosis. Results: The median length of follow-up was 38 months. Postprocedural side branch diameter stenosis differed significantly between the 2 groups (1-stent vs 2-stent, 42.7% vs 9.7%; P <.001). After the performance of inverse-probability-of-treatment-weighting methods, the rate of MACE was significantly higher in the 2-stent group than in the 1-stent group (HR, 1.85; 95%CI, 1.19-2.87; P =.006), mainly driven by target lesion revascularization and stent thrombosis. Conclusions: In STEMI patients with bifurcation culprit lesions undergoing primary PCI, the 2-stent strategy had significantly higher rates of MACE than the 1-stent strategy, despite successful treatment of the side branch. However, this result should be interpreted with caution because this study does not reflect current practice. Full English text available from: www.revespcardiol.org/en

KW - Bifurcation lesions

KW - Drug-eluting stent

KW - Primary percutaneous coronary intervention

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