Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II

Young Bin Song; 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 Tahk; Ki Bae Seung; Ju Hyeon Oh; Jong Seon Park; Hyeon Cheol Gwon

doi:10.1016/j.jcin.2013.11.009

Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II

Young Bin Song, 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 Tahk, Ki Bae Seung, Ju Hyeon Oh, Jong Seon Park, Hyeon Cheol Gwon

Department of Biomedical Sciences

Research output: Contribution to journal › Article › peer-review

65 Citations (Scopus)

Abstract

Objectives: The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions. Background: Few studies have considered anatomic location when comparing 1- and 2-stent strategies for bifurcation lesions. Methods: We compared the prognostic impact of treatment strategies on clinical outcomes in 2,044 patients with non-LM bifurcation lesions and 853 with LM bifurcation lesions. The primary outcome was target lesion failure (TLF) defined as a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization. Results: The 2-stent strategy was used more frequently in the LM bifurcation group than in the non-LM bifurcation group (40.3% vs. 20.8%, p < 0.01). During a median follow-up of 36 months, the 2-stent strategy was not associated with a higher incidence of cardiac death (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 0.72 to 2.14; p = 0.44), cardiac death or MI (HR: 1.12; 95% CI: 0.58 to 2.19; p = 0.73), or TLF (HR: 1.39; 95% CI: 0.99 to 1.94; p = 0.06) in the non-LM bifurcation group. In contrast, in patients with LM bifurcation lesions, the 2-stent strategy was associated with a higher incidence of cardiac death (HR: 2.43; 95% CI: 1.05 to 5.59; p = 0.04), cardiac death or MI (HR: 2.09; 95% CI: 1.08 to 4.04; p = 0.03), as well as TLF (HR: 2.38; 95% CI: 1.60 to 3.55; p < 0.01). Significant interactions were present between treatment strategies and bifurcation lesion locations for TLF (p = 0.01). Conclusions: The 1-stent strategy, if possible, should initially be considered the preferred approach for the treatment of coronary bifurcation lesions, especially LM bifurcation lesions. (Korean Coronary Bifurcation Stenting [COBIS] Registry II; NCT01642992)

Original language	English
Pages (from-to)	255-263
Number of pages	9
Journal	JACC: Cardiovascular Interventions
Volume	7
Issue number	3
DOIs	https://doi.org/10.1016/j.jcin.2013.11.009
Publication status	Published - 2014 Mar

Bibliographical note

Funding Information:
This work was supported by the Korean Society of Interventional Cardiology . The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Keywords

angioplasty
bifurcation lesions
drug-eluting stent(s)
left main

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1016/j.jcin.2013.11.009

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Song, Y. B., 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., Tahk, S. J., Seung, K. B., Oh, J. H., Park, J. S., & Gwon, H. C. (2014). Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II. JACC: Cardiovascular Interventions, 7(3), 255-263. https://doi.org/10.1016/j.jcin.2013.11.009

Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II. / Song, Young Bin; Hahn, Joo Yong; Yang, Jeong Hoon et al.
In: JACC: Cardiovascular Interventions, Vol. 7, No. 3, 03.2014, p. 255-263.

Research output: Contribution to journal › Article › peer-review

Song, YB, Hahn, JY, Yang, JH, Choi, SH, Choi, JH, Lee, SH, Jeong, MH, Kim, HS, Lee, JH, Yu, CW, Rha, SW, Jang, Y, Yoon, JH, Tahk, SJ, Seung, KB, Oh, JH, Park, JS & Gwon, HC 2014, 'Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II', JACC: Cardiovascular Interventions, vol. 7, no. 3, pp. 255-263. https://doi.org/10.1016/j.jcin.2013.11.009

Song YB, Hahn JY, Yang JH, Choi SH, Choi JH, Lee SH et al. Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II. JACC: Cardiovascular Interventions. 2014 Mar;7(3):255-263. doi: 10.1016/j.jcin.2013.11.009

Song, Young Bin ; Hahn, Joo Yong ; Yang, Jeong Hoon et al. / Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention : Results from the COBIS (Coronary Bifurcation Stenting) Registry II. In: JACC: Cardiovascular Interventions. 2014 ; Vol. 7, No. 3. pp. 255-263.

@article{49a0829baac54e9fa89fb66e2291a8b9,

title = "Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II",

abstract = "Objectives: The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions. Background: Few studies have considered anatomic location when comparing 1- and 2-stent strategies for bifurcation lesions. Methods: We compared the prognostic impact of treatment strategies on clinical outcomes in 2,044 patients with non-LM bifurcation lesions and 853 with LM bifurcation lesions. The primary outcome was target lesion failure (TLF) defined as a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization. Results: The 2-stent strategy was used more frequently in the LM bifurcation group than in the non-LM bifurcation group (40.3% vs. 20.8%, p < 0.01). During a median follow-up of 36 months, the 2-stent strategy was not associated with a higher incidence of cardiac death (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 0.72 to 2.14; p = 0.44), cardiac death or MI (HR: 1.12; 95% CI: 0.58 to 2.19; p = 0.73), or TLF (HR: 1.39; 95% CI: 0.99 to 1.94; p = 0.06) in the non-LM bifurcation group. In contrast, in patients with LM bifurcation lesions, the 2-stent strategy was associated with a higher incidence of cardiac death (HR: 2.43; 95% CI: 1.05 to 5.59; p = 0.04), cardiac death or MI (HR: 2.09; 95% CI: 1.08 to 4.04; p = 0.03), as well as TLF (HR: 2.38; 95% CI: 1.60 to 3.55; p < 0.01). Significant interactions were present between treatment strategies and bifurcation lesion locations for TLF (p = 0.01). Conclusions: The 1-stent strategy, if possible, should initially be considered the preferred approach for the treatment of coronary bifurcation lesions, especially LM bifurcation lesions. (Korean Coronary Bifurcation Stenting [COBIS] Registry II; NCT01642992)",

keywords = "angioplasty, bifurcation lesions, drug-eluting stent(s), left main",

author = "Song, {Young Bin} and Hahn, {Joo Yong} and Yang, {Jeong Hoon} and Choi, {Seung Hyuk} and Choi, {Jin Ho} and Lee, {Sang Hoon} and Jeong, {Myung Ho} and Kim, {Hyo Soo} and Lee, {Jae Hwan} and Yu, {Cheol Woong} and Rha, {Seung Woon} and Yangsoo Jang and Yoon, {Jung Han} and Tahk, {Seung Jea} and Seung, {Ki Bae} and Oh, {Ju Hyeon} and Park, {Jong Seon} and Gwon, {Hyeon Cheol}",

note = "Funding Information: This work was supported by the Korean Society of Interventional Cardiology . The authors have reported that they have no relationships relevant to the contents of this paper to disclose. ",

year = "2014",

month = mar,

doi = "10.1016/j.jcin.2013.11.009",

language = "English",

volume = "7",

pages = "255--263",

journal = "JACC: Cardiovascular Interventions",

issn = "1936-8798",

publisher = "Elsevier Inc.",

number = "3",

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TY - JOUR

T1 - Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention

T2 - Results from the COBIS (Coronary Bifurcation Stenting) Registry II

AU - Song, Young Bin

AU - Hahn, Joo Yong

AU - Yang, Jeong Hoon

AU - Choi, Seung Hyuk

AU - Choi, Jin Ho

AU - Lee, Sang Hoon

AU - Jeong, Myung Ho

AU - Kim, Hyo Soo

AU - Lee, Jae Hwan

AU - Yu, Cheol Woong

AU - Rha, Seung Woon

AU - Jang, Yangsoo

AU - Yoon, Jung Han

AU - Tahk, Seung Jea

AU - Seung, Ki Bae

AU - Oh, Ju Hyeon

AU - Park, Jong Seon

AU - Gwon, Hyeon Cheol

N1 - Funding Information: This work was supported by the Korean Society of Interventional Cardiology . The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

PY - 2014/3

Y1 - 2014/3

N2 - Objectives: The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions. Background: Few studies have considered anatomic location when comparing 1- and 2-stent strategies for bifurcation lesions. Methods: We compared the prognostic impact of treatment strategies on clinical outcomes in 2,044 patients with non-LM bifurcation lesions and 853 with LM bifurcation lesions. The primary outcome was target lesion failure (TLF) defined as a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization. Results: The 2-stent strategy was used more frequently in the LM bifurcation group than in the non-LM bifurcation group (40.3% vs. 20.8%, p < 0.01). During a median follow-up of 36 months, the 2-stent strategy was not associated with a higher incidence of cardiac death (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 0.72 to 2.14; p = 0.44), cardiac death or MI (HR: 1.12; 95% CI: 0.58 to 2.19; p = 0.73), or TLF (HR: 1.39; 95% CI: 0.99 to 1.94; p = 0.06) in the non-LM bifurcation group. In contrast, in patients with LM bifurcation lesions, the 2-stent strategy was associated with a higher incidence of cardiac death (HR: 2.43; 95% CI: 1.05 to 5.59; p = 0.04), cardiac death or MI (HR: 2.09; 95% CI: 1.08 to 4.04; p = 0.03), as well as TLF (HR: 2.38; 95% CI: 1.60 to 3.55; p < 0.01). Significant interactions were present between treatment strategies and bifurcation lesion locations for TLF (p = 0.01). Conclusions: The 1-stent strategy, if possible, should initially be considered the preferred approach for the treatment of coronary bifurcation lesions, especially LM bifurcation lesions. (Korean Coronary Bifurcation Stenting [COBIS] Registry II; NCT01642992)

AB - Objectives: The authors sought to investigate whether the impact of treatment strategies on clinical outcomes differed between patients with left main (LM) bifurcation lesions and those with non-LM bifurcation lesions. Background: Few studies have considered anatomic location when comparing 1- and 2-stent strategies for bifurcation lesions. Methods: We compared the prognostic impact of treatment strategies on clinical outcomes in 2,044 patients with non-LM bifurcation lesions and 853 with LM bifurcation lesions. The primary outcome was target lesion failure (TLF) defined as a composite of cardiac death, myocardial infarction (MI), and target lesion revascularization. Results: The 2-stent strategy was used more frequently in the LM bifurcation group than in the non-LM bifurcation group (40.3% vs. 20.8%, p < 0.01). During a median follow-up of 36 months, the 2-stent strategy was not associated with a higher incidence of cardiac death (hazard ratio [HR]: 1.24; 95% confidence interval [CI]: 0.72 to 2.14; p = 0.44), cardiac death or MI (HR: 1.12; 95% CI: 0.58 to 2.19; p = 0.73), or TLF (HR: 1.39; 95% CI: 0.99 to 1.94; p = 0.06) in the non-LM bifurcation group. In contrast, in patients with LM bifurcation lesions, the 2-stent strategy was associated with a higher incidence of cardiac death (HR: 2.43; 95% CI: 1.05 to 5.59; p = 0.04), cardiac death or MI (HR: 2.09; 95% CI: 1.08 to 4.04; p = 0.03), as well as TLF (HR: 2.38; 95% CI: 1.60 to 3.55; p < 0.01). Significant interactions were present between treatment strategies and bifurcation lesion locations for TLF (p = 0.01). Conclusions: The 1-stent strategy, if possible, should initially be considered the preferred approach for the treatment of coronary bifurcation lesions, especially LM bifurcation lesions. (Korean Coronary Bifurcation Stenting [COBIS] Registry II; NCT01642992)

KW - angioplasty

KW - bifurcation lesions

KW - drug-eluting stent(s)

KW - left main

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Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: Results from the COBIS (Coronary Bifurcation Stenting) Registry II

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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