Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice: The COBIS (coronary bifurcation stenting) registry

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

Research output: Contribution to journalArticle

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Abstract

Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2% of lesions and 82.7% of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9%, myocardial infarction (MI) in 1.2%, target lesion revascularization (TLR) in 4.7% and stent thrombosis in 0.7% of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1% vs 7.5%, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95%CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95%CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.

Original languageEnglish
Pages (from-to)2322-2328
Number of pages7
JournalCirculation Journal
Volume74
Issue number11
DOIs
Publication statusPublished - 2010 Nov 1

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Drug-Eluting Stents
Stents
Registries
Confidence Intervals
Myocardial Infarction
Korea
Paclitaxel
Thrombosis

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Gwon, Hyeon Cheol ; Choi, Seung Hyuk ; Song, Young Bin ; Hahn, Joo Yong ; Jeong, Myung Ho ; Seong, In Whan ; Kim, Hyo Soo ; Rha, Seung Woon ; Yang, Ju Young ; Yoon, Jung Han ; Tahk, Seung Jea ; Seung, Ki Bae ; Jang, Yangsoo ; Park, Seung Jung. / Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice : The COBIS (coronary bifurcation stenting) registry. In: Circulation Journal. 2010 ; Vol. 74, No. 11. pp. 2322-2328.
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title = "Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice: The COBIS (coronary bifurcation stenting) registry",
abstract = "Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2{\%} of lesions and 82.7{\%} of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9{\%}, myocardial infarction (MI) in 1.2{\%}, target lesion revascularization (TLR) in 4.7{\%} and stent thrombosis in 0.7{\%} of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1{\%} vs 7.5{\%}, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95{\%} confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95{\%}CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95{\%}CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.",
author = "Gwon, {Hyeon Cheol} and Choi, {Seung Hyuk} and Song, {Young Bin} and Hahn, {Joo Yong} and Jeong, {Myung Ho} and Seong, {In Whan} and Kim, {Hyo Soo} and Rha, {Seung Woon} and Yang, {Ju Young} and Yoon, {Jung Han} and Tahk, {Seung Jea} and Seung, {Ki Bae} and Yangsoo Jang and Park, {Seung Jung}",
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Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice : The COBIS (coronary bifurcation stenting) registry. / Gwon, Hyeon Cheol; Choi, Seung Hyuk; Song, Young Bin; Hahn, Joo Yong; Jeong, Myung Ho; Seong, In Whan; Kim, Hyo Soo; Rha, Seung Woon; Yang, Ju Young; Yoon, Jung Han; Tahk, Seung Jea; Seung, Ki Bae; Jang, Yangsoo; Park, Seung Jung.

In: Circulation Journal, Vol. 74, No. 11, 01.11.2010, p. 2322-2328.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Long-term clinical results and predictors of adverse outcomes after drug-eluting stent implantation for bifurcation lesions in a real-world practice

T2 - The COBIS (coronary bifurcation stenting) registry

AU - Gwon, Hyeon Cheol

AU - Choi, Seung Hyuk

AU - Song, Young Bin

AU - Hahn, Joo Yong

AU - Jeong, Myung Ho

AU - Seong, In Whan

AU - Kim, Hyo Soo

AU - Rha, Seung Woon

AU - Yang, Ju Young

AU - Yoon, Jung Han

AU - Tahk, Seung Jea

AU - Seung, Ki Bae

AU - Jang, Yangsoo

AU - Park, Seung Jung

PY - 2010/11/1

Y1 - 2010/11/1

N2 - Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2% of lesions and 82.7% of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9%, myocardial infarction (MI) in 1.2%, target lesion revascularization (TLR) in 4.7% and stent thrombosis in 0.7% of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1% vs 7.5%, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95%CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95%CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.

AB - Background: Limited data exists regarding long-term clinical results and predictors of adverse outcomes after drug-eluting stents (DES) implantation for coronary bifurcation lesions in a real-world practice. Methods and Results: A total of 1,691 non-left main bifurcation lesions with side branches ≥ 2.0 mm in 1,668 patients undergoing DES implantation between January 2004 and June 2006 from 16 centers in Korea were evaluated. True bifurcation was found in 69.2% of lesions and 82.7% of lesions were treated with 1-stent technique. During follow-up (median 22 months), cardiac death occurred in 0.9%, myocardial infarction (MI) in 1.2%, target lesion revascularization (TLR) in 4.7% and stent thrombosis in 0.7% of patients. There was no significant difference in major adverse cardiac events (MACE: composite of cardiac death, MI and TLR) between the 1-stent and the 2-stent groups (6.1% vs 7.5%, P=0.36). Stent length in the main vessel (hazard ratio (HR) 1.02, 95% confidence interval (CI) 1.001-1.03, P=0.03), paclitaxel-eluting stent (HR 1.98, 95%CI 1.34-2.92, P=0.001) and kissing ballooning (HR 2.01, 95%CI 1.29-3.13, P=0.002) were independent predictors of MACE. Kissing ballooning increased the risk of MACE especially in the 1-stent group, but not in the 2-stent group. Conclusions: In this large real-world registry, overall outcomes after DES implantation in bifurcation lesions were favorable and similar between the 1-stent and 2-stent groups.

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U2 - 10.1253/circj.CJ-10-0352

DO - 10.1253/circj.CJ-10-0352

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C2 - 20890049

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VL - 74

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JO - Circulation Journal

JF - Circulation Journal

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