Comparison of the planned one‐ and elective two‐stent techniques in patients with coronary bifurcation lesions with or without acute coronary syndrome from the COBIS II Registry. Issue 6 (24th March 2018)

• Record Type: Journal Article
• Authors: Kim, Min Chul; Ahn, Youngkeun; Sun Sim, Doo; Joon Hong, Young; Han Kim, Ju; Ho Jeong, Myung; Gwon, Hyeon‐Cheol; Kim, Hyo‐Soo; Rha, Seung Woon; Yoon, Jung Han; Jang, Yangsoo; Tahk, Seung‐Jea; Seung, Ki Bae
• Is Part Of: Catheterization and cardiovascular interventions. Volume 92:Issue 6(2018)
• Page Start: 1050
• Page End: 1060
• Publication Date: 2018-03-24
• Subjects: acute coronary syndrome -- coronary bifurcation -- percutaneous coronary intervention; Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.27551
• Languages: English
• ISSNs: 1522-1946

Abstract

Abstract: Objectives: To evaluate the impacts of stent techniques on long‐term clinical outcomes after percutaneous coronary intervention (PCI) using drug‐eluting stents (DES) for coronary bifurcation lesions in patients with or without acute coronary syndrome (ACS). Background: Few studies have investigated the impacts of stent techniques for treating coronary bifurcation lesions in patients with and without ACS. Methods: This multicenter registry enrolled 2, 897 patients undergoing PCI with DES for coronary bifurcation lesions. We investigated the impacts of planned one‐stent and elective two‐stent techniques in patients with ( n = 1, 798) and those without ( n = 1, 099) ACS. Primary endpoint was the incidence of 3‐year target‐lesion failure (TLF), defined as a composite of cardiac death, spontaneous myocardial infarction, and target‐lesion revascularization. Results: The planned one‐stent technique reduced TLF rate compared to elective two‐stent technique in the ACS cohort (hazard ratio [HR] 0.49; 95% confidence interval [CI] 0.34–0.74; P = 0.001), and not in the non‐ACS cohort (HR 0.61; 95% CI 0.35–1.06; P = 0.079). After propensity score matching, the planned one‐stent technique had a significantly lower TLF rate (HR 0.47; 95% CI 0.29–0.74; P = 0.001) in patients with ACS, and it also showed a trend toward lower TLF rate with the planned one‐stent technique in patients without ACS (9.0 vs. 14.5%, HR 0.59; 95% CI 0.32–1.14; P = 0.116). Conclusions: Planned one‐stenting reduced TLF in patients with ACS and it also might be beneficial in those without ACS for the treatment of coronary bifurcation lesions.