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Differential Prognostic Effect Between First- and Second-Generation Drug-Eluting Stents in Coronary Bifurcation Lesions: Patient-Level Analysis of the Korean Bifurcation Pooled Cohorts.

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dc.contributor.authorLee, JM-
dc.contributor.authorHahn, JY-
dc.contributor.authorKang, J-
dc.contributor.authorPark, KW-
dc.contributor.authorChun, WJ-
dc.contributor.authorRha, SW-
dc.contributor.authorYu, CW-
dc.contributor.authorJeong, JO-
dc.contributor.authorJeong, MH-
dc.contributor.authorYoon, JH-
dc.contributor.authorJang, Y-
dc.contributor.authorTahk, SJ-
dc.contributor.authorGwon, HC-
dc.contributor.authorKoo, BK-
dc.contributor.authorKim, HS-
dc.date.accessioned2017-03-28T05:36:55Z-
dc.date.available2017-03-28T05:36:55Z-
dc.date.issued2015-
dc.identifier.issn1936-8798-
dc.identifier.urihttp://repository.ajou.ac.kr/handle/201003/13656-
dc.description.abstractOBJECTIVES: The purpose of this study was to investigate the differential clinical outcomes after percutaneous coronary intervention (PCI) for coronary bifurcation lesions with 1- or 2-stenting techniques using first- or second-generation drug-eluting stents (DES).

BACKGROUND: The 2-stenting technique has been regarded to have worse clinical outcomes than the 1-stenting technique after bifurcation PCI with first-generation DES. However, there has been a paucity of data comparing the 1- and 2-stenting techniques with the use of second-generation DES.

METHODS: Patient-level pooled analysis was performed with 3,162 patients undergoing PCI using first- or second-generation DES for bifurcation lesions from the "Korean Bifurcation Pooled Cohorts" (COBIS [Coronary Bifurcation Stenting] II, EXCELLENT [Registry to Evaluate Efficacy of Xience/Promus Versus Cypher in Reducing Late Loss After Stenting], and RESOLUTE-Korea [Registry to Evaluate the Efficacy of Zotarolimus-Eluting Stent]). The 3-year clinical outcomes were compared between 1- and 2-stenting techniques, stratified by the type of DES.

RESULTS: With first-generation DES, rates of target lesion failure (TLF) or patient-oriented composite outcome (POCO) (a composite of all death, any myocardial infarction, any repeat revascularization, and cerebrovascular accidents) at 3 years were significantly higher after the 2-stenting than the 1-stenting technique (TLF 8.6% vs. 17.5%; p < 0.001; POCO 18.1% vs. 28.5%, p < 0.001). With second-generation DES, however, there was no difference between 1- and 2-stenting techniques (TLF 5.4% vs. 5.8%; p = 0.768; POCO 11.2% vs. 12.9%; p = 0.995). The differential effects of 2-stenting technique on the prognosis according to the type of DES were also corroborated with similar results by the inverse probability weighted model. The 2-stenting technique was a significant independent predictor of TLF in first-generation DES (hazard ratio: 2.046; 95% confidence interval: 1.114 to 3.759; p < 0.001), but not in second-generation DES (hazard ratio: 0.667; 95% confidence interval: 0.247 to 1.802; p = 0.425).

CONCLUSIONS: Patient-level pooled analysis of 3,162 patients in Korean Bifurcation Pooled Cohorts demonstrated that the 2-stenting technique showed comparable outcomes to 1-stenting technique with second-generation DES, which is different from the results of first-generation DES favoring the 1-stenting technique.
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dc.language.isoen-
dc.subject.MESHAged-
dc.subject.MESHCardiovascular Agents-
dc.subject.MESHCoronary Angiography-
dc.subject.MESHCoronary Artery Disease-
dc.subject.MESHCoronary Circulation-
dc.subject.MESHCoronary Vessels-
dc.subject.MESHDrug-Eluting Stents-
dc.subject.MESHFemale-
dc.subject.MESHHumans-
dc.subject.MESHKaplan-Meier Estimate-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHMyocardial Infarction-
dc.subject.MESHPercutaneous Coronary Intervention-
dc.subject.MESHProportional Hazards Models-
dc.subject.MESHProsthesis Design-
dc.subject.MESHRegistries-
dc.subject.MESHRepublic of Korea-
dc.subject.MESHRisk Factors-
dc.subject.MESHSirolimus-
dc.subject.MESHTime Factors-
dc.subject.MESHTreatment Outcome-
dc.titleDifferential Prognostic Effect Between First- and Second-Generation Drug-Eluting Stents in Coronary Bifurcation Lesions: Patient-Level Analysis of the Korean Bifurcation Pooled Cohorts.-
dc.typeArticle-
dc.identifier.pmid26315734-
dc.identifier.urlhttps://linkinghub.elsevier.com/retrieve/pii/S1936-8798(15)00816-X-
dc.contributor.affiliatedAuthor탁, 승제-
dc.type.localJournal Papers-
dc.identifier.doi10.1016/j.jcin.2015.05.014-
dc.citation.titleJACC. Cardiovascular interventions-
dc.citation.volume8-
dc.citation.number10-
dc.citation.date2015-
dc.citation.startPage1318-
dc.citation.endPage1331-
dc.identifier.bibliographicCitationJACC. Cardiovascular interventions, 8(10). : 1318-1331, 2015-
dc.identifier.eissn1876-7605-
dc.relation.journalidJ019368798-
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
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