Impact of calcified bifurcation lesions in patients undergoing percutaneous coronary intervention using drug-eluting stents: Results from the COronary BIfurcation Stent (COBIS) II registry

Min Chul Kim, Youngkeun Ahn, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Hyeon Cheol Gwon, Hyo Soo Kim, Seung Woon Rha, Jung Han Yoon, Yangsoo Jang, Seung Jea Tahk, Ki Bae Seung

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aims: Few data regarding clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions are available. We therefore aimed to evaluate the clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) using a large-scale multicentre Korean registry. Methods and results: This prospective, multicentre, observational registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions. We compared target lesion failure (TLF), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target lesion revascularisation (TLR), according to severity of calcification in coronary bifurcation target lesions, assessed by an angiographic core laboratory using quantitative coronary angiography. Moderate or severe calcification of target bifurcation lesions was observed in 608 (20.9%) patients. During a median follow-up period of 36 months, moderate or severe calcification increased the adjusted risks of TLF (hazard ratio [HR] 1.31, 95% confidence interval [CI]: 1.03-1.68, p=0.031), TLR (HR 1.36, 95% CI: 1.04-1.79, p=0.027), and revascularisation (HR 1.39, 95% CI: 1.09-1.78, p=0.009). However, it was not associated with an increased risk of cardiac death, MI, or stent thrombosis. Conclusions: Moderate or severe calcification of coronary bifurcation lesions is not uncommon and is associated with unfavourable long-term clinical outcomes, driven mainly by an increased frequency of repeat revascularisation.

Original languageEnglish
Pages (from-to)338-344
Number of pages7
JournalEuroIntervention
Volume13
Issue number3
DOIs
Publication statusPublished - 2017 Jun

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Drug-Eluting Stents
Percutaneous Coronary Intervention
Stents
Registries
Confidence Intervals
Myocardial Infarction
Coronary Angiography
Thrombosis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Min Chul ; Ahn, Youngkeun ; Sim, Doo Sun ; Hong, Young Joon ; Kim, Ju Han ; Jeong, Myung Ho ; Gwon, Hyeon Cheol ; Kim, Hyo Soo ; Rha, Seung Woon ; Yoon, Jung Han ; Jang, Yangsoo ; Tahk, Seung Jea ; Seung, Ki Bae. / Impact of calcified bifurcation lesions in patients undergoing percutaneous coronary intervention using drug-eluting stents : Results from the COronary BIfurcation Stent (COBIS) II registry. In: EuroIntervention. 2017 ; Vol. 13, No. 3. pp. 338-344.
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title = "Impact of calcified bifurcation lesions in patients undergoing percutaneous coronary intervention using drug-eluting stents: Results from the COronary BIfurcation Stent (COBIS) II registry",
abstract = "Aims: Few data regarding clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions are available. We therefore aimed to evaluate the clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) using a large-scale multicentre Korean registry. Methods and results: This prospective, multicentre, observational registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions. We compared target lesion failure (TLF), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target lesion revascularisation (TLR), according to severity of calcification in coronary bifurcation target lesions, assessed by an angiographic core laboratory using quantitative coronary angiography. Moderate or severe calcification of target bifurcation lesions was observed in 608 (20.9{\%}) patients. During a median follow-up period of 36 months, moderate or severe calcification increased the adjusted risks of TLF (hazard ratio [HR] 1.31, 95{\%} confidence interval [CI]: 1.03-1.68, p=0.031), TLR (HR 1.36, 95{\%} CI: 1.04-1.79, p=0.027), and revascularisation (HR 1.39, 95{\%} CI: 1.09-1.78, p=0.009). However, it was not associated with an increased risk of cardiac death, MI, or stent thrombosis. Conclusions: Moderate or severe calcification of coronary bifurcation lesions is not uncommon and is associated with unfavourable long-term clinical outcomes, driven mainly by an increased frequency of repeat revascularisation.",
author = "Kim, {Min Chul} and Youngkeun Ahn and Sim, {Doo Sun} and Hong, {Young Joon} and Kim, {Ju Han} and Jeong, {Myung Ho} and Gwon, {Hyeon Cheol} and Kim, {Hyo Soo} and Rha, {Seung Woon} and Yoon, {Jung Han} and Yangsoo Jang and Tahk, {Seung Jea} and Seung, {Ki Bae}",
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Impact of calcified bifurcation lesions in patients undergoing percutaneous coronary intervention using drug-eluting stents : Results from the COronary BIfurcation Stent (COBIS) II registry. / Kim, Min Chul; Ahn, Youngkeun; Sim, Doo Sun; Hong, Young Joon; Kim, Ju Han; Jeong, Myung Ho; Gwon, Hyeon Cheol; Kim, Hyo Soo; Rha, Seung Woon; Yoon, Jung Han; Jang, Yangsoo; Tahk, Seung Jea; Seung, Ki Bae.

In: EuroIntervention, Vol. 13, No. 3, 06.2017, p. 338-344.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Impact of calcified bifurcation lesions in patients undergoing percutaneous coronary intervention using drug-eluting stents

T2 - Results from the COronary BIfurcation Stent (COBIS) II registry

AU - Kim, Min Chul

AU - Ahn, Youngkeun

AU - Sim, Doo Sun

AU - Hong, Young Joon

AU - Kim, Ju Han

AU - Jeong, Myung Ho

AU - Gwon, Hyeon Cheol

AU - Kim, Hyo Soo

AU - Rha, Seung Woon

AU - Yoon, Jung Han

AU - Jang, Yangsoo

AU - Tahk, Seung Jea

AU - Seung, Ki Bae

PY - 2017/6

Y1 - 2017/6

N2 - Aims: Few data regarding clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions are available. We therefore aimed to evaluate the clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) using a large-scale multicentre Korean registry. Methods and results: This prospective, multicentre, observational registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions. We compared target lesion failure (TLF), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target lesion revascularisation (TLR), according to severity of calcification in coronary bifurcation target lesions, assessed by an angiographic core laboratory using quantitative coronary angiography. Moderate or severe calcification of target bifurcation lesions was observed in 608 (20.9%) patients. During a median follow-up period of 36 months, moderate or severe calcification increased the adjusted risks of TLF (hazard ratio [HR] 1.31, 95% confidence interval [CI]: 1.03-1.68, p=0.031), TLR (HR 1.36, 95% CI: 1.04-1.79, p=0.027), and revascularisation (HR 1.39, 95% CI: 1.09-1.78, p=0.009). However, it was not associated with an increased risk of cardiac death, MI, or stent thrombosis. Conclusions: Moderate or severe calcification of coronary bifurcation lesions is not uncommon and is associated with unfavourable long-term clinical outcomes, driven mainly by an increased frequency of repeat revascularisation.

AB - Aims: Few data regarding clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions are available. We therefore aimed to evaluate the clinical outcomes according to severity of calcification in patients with coronary bifurcation target lesions after percutaneous coronary intervention (PCI) with drug-eluting stents (DES) using a large-scale multicentre Korean registry. Methods and results: This prospective, multicentre, observational registry enrolled 2,897 patients undergoing PCI with DES for coronary bifurcation lesions. We compared target lesion failure (TLF), defined as a composite of cardiac death, non-fatal myocardial infarction (MI), and target lesion revascularisation (TLR), according to severity of calcification in coronary bifurcation target lesions, assessed by an angiographic core laboratory using quantitative coronary angiography. Moderate or severe calcification of target bifurcation lesions was observed in 608 (20.9%) patients. During a median follow-up period of 36 months, moderate or severe calcification increased the adjusted risks of TLF (hazard ratio [HR] 1.31, 95% confidence interval [CI]: 1.03-1.68, p=0.031), TLR (HR 1.36, 95% CI: 1.04-1.79, p=0.027), and revascularisation (HR 1.39, 95% CI: 1.09-1.78, p=0.009). However, it was not associated with an increased risk of cardiac death, MI, or stent thrombosis. Conclusions: Moderate or severe calcification of coronary bifurcation lesions is not uncommon and is associated with unfavourable long-term clinical outcomes, driven mainly by an increased frequency of repeat revascularisation.

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U2 - 10.4244/EIJ-D-16-00264

DO - 10.4244/EIJ-D-16-00264

M3 - Article

C2 - 27867140

AN - SCOPUS:85021123155

VL - 13

SP - 338

EP - 344

JO - EuroIntervention

JF - EuroIntervention

SN - 1774-024X

IS - 3

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