Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification – Results From the COBIS (COronary BIfurcation Stent) II Registry
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 comp...
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| Veröffentlicht in: | Circulation Journal 2015/08/25, Vol.79(9), pp.1954-1962 |
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| container_title | Circulation Journal |
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| creator | 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 |
| description | 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. (Circ J 2015; 79: 1954–1962) |
| doi_str_mv | 10.1253/circj.CJ-15-0264 |
| format | Article |
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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. (Circ J 2015; 79: 1954–1962)</description><identifier>ISSN: 1346-9843</identifier><identifier>EISSN: 1347-4820</identifier><identifier>DOI: 10.1253/circj.CJ-15-0264</identifier><identifier>PMID: 26134457</identifier><language>eng</language><publisher>Japan: The Japanese Circulation Society</publisher><subject>Aged ; Angioplasty ; Death ; Female ; Humans ; Male ; Medina classification ; Middle Aged ; Myocardial Infarction - etiology ; Myocardial Infarction - mortality ; Percutaneous Coronary Intervention - adverse effects ; Postoperative Complications - mortality ; Registries ; True bifurcation lesion</subject><ispartof>Circulation Journal, 2015/08/25, Vol.79(9), pp.1954-1962</ispartof><rights>2015 THE JAPANESE CIRCULATION SOCIETY</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c622t-1b2faf012ee18a209bd3d8c38f42b562b2544f889f54015deffbc4c696e741373</citedby><cites>FETCH-LOGICAL-c622t-1b2faf012ee18a209bd3d8c38f42b562b2544f889f54015deffbc4c696e741373</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,1877,4010,27900,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26134457$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Park, Taek Kyu</creatorcontrib><creatorcontrib>Park, Yong Hwan</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Oh, Ju Hyeon</creatorcontrib><creatorcontrib>Chun, Woo Jung</creatorcontrib><creatorcontrib>Kang, Gu Hyun</creatorcontrib><creatorcontrib>Jang, Woo Jin</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><creatorcontrib>Lee, Sang Hoon</creatorcontrib><creatorcontrib>Jeong, Myung-Ho</creatorcontrib><creatorcontrib>Kim, Hyo-Soo</creatorcontrib><creatorcontrib>Lee, Jae-Hwan</creatorcontrib><creatorcontrib>Yu, Cheol Woong</creatorcontrib><creatorcontrib>Rha, Seung Woon</creatorcontrib><creatorcontrib>Jang, Yangsoo</creatorcontrib><creatorcontrib>Yoon, Jung Han</creatorcontrib><creatorcontrib>Tahk, Seung-Jea</creatorcontrib><creatorcontrib>Seung, Ki Bae</creatorcontrib><creatorcontrib>Park, Jong-Seon</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><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</title><title>Circulation Journal</title><addtitle>Circ J</addtitle><description>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. (Circ J 2015; 79: 1954–1962)</description><subject>Aged</subject><subject>Angioplasty</subject><subject>Death</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medina classification</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - etiology</subject><subject>Myocardial Infarction - mortality</subject><subject>Percutaneous Coronary Intervention - adverse effects</subject><subject>Postoperative Complications - mortality</subject><subject>Registries</subject><subject>True bifurcation lesion</subject><issn>1346-9843</issn><issn>1347-4820</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpFkctu1DAUhiMEohfYs0JelkWK7di5LDtRB1INjESHteU4x1OPErvYzqK7eQeeg5cqL0LmQmfjcyx__ydZf5J8IPiaUJ59VsarzXV9lxKeYpqzV8k5yViRspLi1_s9T6uSZWfJRQgbjGmFefU2OaP59MR4cZ78WTi7TlfgB1T3xhole7Qco3IDBOQ0WvkRkLQd-u5sur_MjB69ktE4ixYQphHQjVLOd8auUXToG0ybnHQyBKPNAf273T5vf6MfEMY-BjT3bkDxAVC9nDX36Kpeemelf0Kz5mS_j2DjJ9Q0U2xtQvRP75I3WvYB3h_nZfJzfruqv6aL5ZemvlmkKqc0pqSlWmpMKAApJcVV22VdqbJSM9rynLaUM6bLstKcYcI70LpVTOVVDgUjWZFdJlcH76N3v0YIUQwmKOh7acGNQZAClyQnFeMTig-o8i4ED1o8ejNMXxEEi11JYl-SqO8E4WJX0hT5eLSP7QDdS-B_KxMwPwCbEOUaXgDpo1E9HI1FJardcTKfgAfpBdjsH0ZCqt0</recordid><startdate>2015</startdate><enddate>2015</enddate><creator>Park, Taek Kyu</creator><creator>Park, Yong Hwan</creator><creator>Song, Young Bin</creator><creator>Oh, Ju Hyeon</creator><creator>Chun, Woo Jung</creator><creator>Kang, Gu Hyun</creator><creator>Jang, Woo Jin</creator><creator>Hahn, Joo-Yong</creator><creator>Yang, Jeong Hoon</creator><creator>Choi, Seung-Hyuk</creator><creator>Choi, Jin-Ho</creator><creator>Lee, Sang Hoon</creator><creator>Jeong, Myung-Ho</creator><creator>Kim, Hyo-Soo</creator><creator>Lee, Jae-Hwan</creator><creator>Yu, Cheol Woong</creator><creator>Rha, Seung Woon</creator><creator>Jang, Yangsoo</creator><creator>Yoon, Jung Han</creator><creator>Tahk, Seung-Jea</creator><creator>Seung, Ki Bae</creator><creator>Park, Jong-Seon</creator><creator>Gwon, Hyeon-Cheol</creator><general>The Japanese Circulation Society</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>2015</creationdate><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</title><author>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</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c622t-1b2faf012ee18a209bd3d8c38f42b562b2544f889f54015deffbc4c696e741373</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Angioplasty</topic><topic>Death</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medina classification</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - etiology</topic><topic>Myocardial Infarction - mortality</topic><topic>Percutaneous Coronary Intervention - adverse effects</topic><topic>Postoperative Complications - mortality</topic><topic>Registries</topic><topic>True bifurcation lesion</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Park, Taek Kyu</creatorcontrib><creatorcontrib>Park, Yong Hwan</creatorcontrib><creatorcontrib>Song, Young Bin</creatorcontrib><creatorcontrib>Oh, Ju Hyeon</creatorcontrib><creatorcontrib>Chun, Woo Jung</creatorcontrib><creatorcontrib>Kang, Gu Hyun</creatorcontrib><creatorcontrib>Jang, Woo Jin</creatorcontrib><creatorcontrib>Hahn, Joo-Yong</creatorcontrib><creatorcontrib>Yang, Jeong Hoon</creatorcontrib><creatorcontrib>Choi, Seung-Hyuk</creatorcontrib><creatorcontrib>Choi, Jin-Ho</creatorcontrib><creatorcontrib>Lee, Sang Hoon</creatorcontrib><creatorcontrib>Jeong, Myung-Ho</creatorcontrib><creatorcontrib>Kim, Hyo-Soo</creatorcontrib><creatorcontrib>Lee, Jae-Hwan</creatorcontrib><creatorcontrib>Yu, Cheol Woong</creatorcontrib><creatorcontrib>Rha, Seung Woon</creatorcontrib><creatorcontrib>Jang, Yangsoo</creatorcontrib><creatorcontrib>Yoon, Jung Han</creatorcontrib><creatorcontrib>Tahk, Seung-Jea</creatorcontrib><creatorcontrib>Seung, Ki Bae</creatorcontrib><creatorcontrib>Park, Jong-Seon</creatorcontrib><creatorcontrib>Gwon, Hyeon-Cheol</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation Journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Park, Taek Kyu</au><au>Park, Yong Hwan</au><au>Song, Young Bin</au><au>Oh, Ju Hyeon</au><au>Chun, Woo Jung</au><au>Kang, Gu Hyun</au><au>Jang, Woo Jin</au><au>Hahn, Joo-Yong</au><au>Yang, Jeong Hoon</au><au>Choi, Seung-Hyuk</au><au>Choi, Jin-Ho</au><au>Lee, Sang Hoon</au><au>Jeong, Myung-Ho</au><au>Kim, Hyo-Soo</au><au>Lee, Jae-Hwan</au><au>Yu, Cheol Woong</au><au>Rha, Seung Woon</au><au>Jang, Yangsoo</au><au>Yoon, Jung Han</au><au>Tahk, Seung-Jea</au><au>Seung, Ki Bae</au><au>Park, Jong-Seon</au><au>Gwon, Hyeon-Cheol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification – Results From the COBIS (COronary BIfurcation Stent) II Registry</atitle><jtitle>Circulation Journal</jtitle><addtitle>Circ J</addtitle><date>2015</date><risdate>2015</risdate><volume>79</volume><issue>9</issue><spage>1954</spage><epage>1962</epage><pages>1954-1962</pages><issn>1346-9843</issn><eissn>1347-4820</eissn><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. (Circ J 2015; 79: 1954–1962)</abstract><cop>Japan</cop><pub>The Japanese Circulation Society</pub><pmid>26134457</pmid><doi>10.1253/circj.CJ-15-0264</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Circulation Journal, 2015/08/25, Vol.79(9), pp.1954-1962 |
| issn | 1346-9843 1347-4820 |
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| source | MEDLINE; J-STAGE (Japan Science & Technology Information Aggregator, Electronic) Freely Available Titles - Japanese; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Aged Angioplasty Death Female Humans Male Medina classification Middle Aged Myocardial Infarction - etiology Myocardial Infarction - mortality Percutaneous Coronary Intervention - adverse effects Postoperative Complications - mortality Registries True bifurcation lesion |
| 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 |
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