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Ten-Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques

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Author(s)
Joo Myung LeeSeung Hun LeeJuwon KimKi Hong ChoiTaek Kyu ParkJeong Hoon YangYoung Bin SongJoo‐Yong HahnJin‐Ho ChoiSeung‐Hyuk ChoiHyo‐Soo KimWoo Jung ChunChang‐Wook NamSeung‐Ho HurSeung Hwan HanSeung‐Woon RhaIn‐Ho ChaeJin‐Ok JeongJung Ho HeoJunghan YoonDo‐Sun LimJong‐Seon ParkMyeong‐Ki HongJoon‐Hyung DohKwang Soo ChaDoo‐Il KimSang Yeub LeeKiyuk ChangByung‐Hee HwangSo‐Yeon ChoiMyung Ho JeongSoon‐Jun HongBon‐Kwon KooHyeon‐Cheol Gwon
Keimyung Author(s)
Nam, Chang WookHur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Am Heart Assoc
Issued Date
2021
Volume
10
Issue
18
Keyword
clinical outcomecoronary bifurcation lesiondrug-eluting stentpercutaneous coronary intervention
Abstract
Background:
Despite advances in devices and techniques, coronary bifurcation lesion remains a challenging lesion subset in the field of percutaneous coronary intervention (PCI). We evaluate 10‐year trends in bifurcation PCI and their effects on patient outcomes.

Methods and Results:
We analyzed 10‐year trends in patient/lesion characteristics, devices, PCI strategy, stent optimization techniques, and clinical outcomes using data from 5498 patients who underwent bifurcation PCI from 2004 to 2015. Clinical outcomes 2 years after the index procedure were evaluated in terms of target vessel failure (a composite of cardiac death, myocardial infarction, and target vessel revascularization) and a patient‐oriented composite outcome (a composite of all‐cause death, myocardial infarction, and any revascularization). During the 10‐year study period, patient and lesion complexity, such as multivessel disease, diabetes mellitus, chronic kidney disease, and left main bifurcation, increased continuously (all P<0.001). The risk of target vessel failure or patient‐oriented composite outcome decreased continuously from 2004 to 2015 (target vessel failure: from 12.3% to 6.9%, log‐rank P<0.001; patient‐oriented composite outcome: from 13.6% to 9.3%, log‐rank P<0.001). The use of a second‐generation drug‐eluting stent and decreased target vessel failure risk in true bifurcation lesions were the major contributors to improved patient prognosis (interaction P values were <0.001 and 0.013, respectively).

Conclusions:
During the past decade of bifurcation PCI, patient and lesion characteristics, devices, PCI techniques, and patient prognosis have all significantly changed. Despite increased patient and lesion complexity, clinical outcomes after bifurcation PCI have improved, mainly because of better devices and more widespread adoption of procedural optimization techniques and appropriate treatment strategies.
Keimyung Author(s)(Kor)
남창욱
허승호
Publisher
School of Medicine (의과대학)
Citation
Joo Myung Lee et al. (2021). Ten-Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques. J Am Heart Assoc, 10(18), e021632. doi: 10.1161/JAHA.121.021632
Type
Article
ISSN
2047-9980
Source
https://www.ahajournals.org/doi/10.1161/JAHA.121.021632
DOI
10.1161/JAHA.121.021632
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44035
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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