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Final kissing ballooning and long-term clinical outcomes in coronary bifurcation lesions treated with 1-stent technique: results from the COBIS registry

Authors
Gwon, HC; Hahn, JY; Koo, BK; Song, YB; Choi, SH; Choi, JH; Lee, SH; Jeong, MH; Kim, HS; Seong, IW; Yang, JY; Rha, SW; Jang, Y; Yoon, JH; Tahk, SJ; Seung, KB; Park, SJ
Citation
Heart (British Cardiac Society), 98(3):225-231, 2012
Journal Title
Heart (British Cardiac Society)
ISSN
1355-60371468-201X
Abstract
BACKGROUND: Whether final kissing ballooning (FKB) is mandatory in the 1-stent technique is uncertain.



OBJECTIVE: To evaluate the effect of FKB on long-term clinical outcomes in coronary bifurcation lesions treated with the 1-stent technique.



METHODS: Consecutive patients undergoing percutaneous coronary intervention using drug-eluting stents for non-left main bifurcation lesions were enrolled from 16 centres in Korea between January 2004 and June 2006. In patients treated with the 1-stent technique major adverse cardiac events (MACE; cardiac death, myocardial infarction (MI), or target lesion revascularisation (TLR)) were compared between those undergoing main vessel stenting only (non-FKB group, n=736) or those undergoing FKB after main vessel stenting (FKB group, n=329). Propensity score-matching analysis was also performed in 222 patient pairs (444 from the non-FKB group and 222 from the FKB group).



RESULTS: During follow-up (median 22 months), the FKB group had a higher incidence of MACE (HR 2.58; 95% CI 1.52 to 4.37; p<0.001) and TLR (HR 3.63; 95% CI 2.00 to 6.56; p<0.001), but not of cardiac death or MI. Most TLR occurred in the main vessel (HR 3.39 for the FKB group; 95% CI 1.86 to 6.19; p<0.001). The rate of stent thrombosis was similar in both groups (0.5% in the non-FKB group vs 0.6% in the FKB group, p=0.99). After propensity score matching, the FKB group still had higher rates of MACE and TLR than the non-FKB group (HR 2.13; 95% CI 1.15 to 3.95; p=0.02 and HR 2.84; 95% CI 1.45 to 5.55; p=0.002, respectively).



CONCLUSIONS: In patients treated with the 1-stent technique for bifurcation lesions, FKB after main vessel stenting may be harmful mainly due to increased TLR.



TRIAL REGISTRATION NUMBER: clinicaltrials.gov number: NCT00851526.
MeSH terms
Angioplasty, Balloon, Coronary/*instrumentationCause of DeathCoronary AngiographyCoronary Stenosis/mortality/radiography/*surgeryElectrocardiographyEquipment DesignFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedPostoperative Complications/epidemiologyPropensity ScoreProsthesis Design*RegistriesRepublic of Korea/epidemiologyRetrospective StudiesRisk Factors*StentsSurvival Rate/trendsTime FactorsTreatment Outcome
DOI
10.1136/heartjnl-2011-300322
PMID
21933939
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
탁, 승제
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