Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry

Taek Kyu Park, Yong Hwan Park, Young Bin Song, Ju Hyeon Oh, Woo Jung Chun, Gu Hyun Kang, Woo Jin Jang, Joo Yong Hahn, Jeong Hoon Yang, Seung Hyuk Choi, Jin Ho Choi, Sang Hoon Lee, Myung Ho Jeong, Hyo Soo Kim, Jae Hwan Lee, Cheol Woong Yu, Seung Woon Rha, Yangsoo Jang, Jung Han Yoon, Seung Jea TahkKi Bae Seung, Jong Seon Park, Hyeon Cheol Gwon

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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.

Original languageEnglish
Pages (from-to)1954-1962
Number of pages9
JournalCirculation Journal
Volume79
Issue number9
DOIs
Publication statusPublished - 2015 Aug 25

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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Park, T. K., Park, Y. H., Song, Y. B., Oh, J. H., Chun, W. J., Kang, G. H., Jang, W. J., Hahn, J. Y., Yang, J. H., Choi, S. H., Choi, J. H., Lee, S. H., Jeong, M. H., Kim, H. S., Lee, J. H., Yu, C. W., Rha, S. W., Jang, Y., Yoon, J. H., ... Gwon, H. C. (2015). Long-term clinical outcomes of true and non-true bifurcation lesions according to medina classification - Results from the COBIS (COronary BIfurcation stent) II registry. Circulation Journal, 79(9), 1954-1962. https://doi.org/10.1253/circj.CJ-15-0264