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Bifurcation strategies using second-generation drug-eluting stents on clinical outcomes in diabetic patients

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Author(s)
Jung-Joon ChaSoon Jun HongJu Hyeon KimSubin LimHyung Joon JooJae Hyoung ParkCheol Woong YuJeehoon KangHyo-Soo KimHyeon-Cheol GwonWoo Jung ChunSeung-Ho HurSeung Hwan HanSeung-Woon RhaIn-Ho ChaeJin-Ok JeongJung Ho HeoJunghan YoonJong-Seon ParkMyeong-Ki HongJoon-Hyung DohKwang Soo ChaDoo-Il KimSang Yeub LeeKiyuk ChangByung-Hee HwangSo-Yeon ChoiMyung Ho JeongYoung Bin SongKi Hong ChoiChang-Wook NamBon-Kwon KooDo-Sun Lim
Keimyung Author(s)
Hur, Seung HoNam, Chang Wook
Department
Dept. of Internal Medicine (내과학)
Journal Title
Front Cardiovasc Med
Issued Date
2022
Volume
9
Keyword
clinical outcomecoronary bifurcation angioplastydiabetes mellituspercutaneous coronary intervention (complex PCI)second-generation drug-eluting stentstent strategy
Abstract
Background:
Diabetes mellitus (DM) is a critical risk factor for the pathogenesis and progression of coronary artery disease, with a higher prevalence of complex coronary artery disease, including bifurcation lesions. This study aimed to elucidate the optimal stenting strategy for coronary bifurcation lesions in patients with DM.

Methods:
A total of 905 patients with DM and bifurcation lesions treated with second-generation drug-eluting stents (DES) from a multicenter retrospective patient cohort were analyzed. The primary outcome was the 5-year incidence of target lesion failure (TLF), which was defined as a composite of cardiac death, target vessel myocardial infarction, and target lesion revascularization.

Results:
Among all patients with DM with significant bifurcation lesions, 729 (80.6%) and 176 (19.4%) were treated with one- and two-stent strategies, respectively. TLF incidence differed according to the stenting strategy during the mean follow-up of 42 ± 20 months. Among the stent strategies, T- and V-stents were associated with a higher TLF incidence than one-stent strategy (24.0 vs. 7.3%, p < 0.001), whereas no difference was observed in TLF between the one-stent strategy and crush or culotte technique (7.3 vs. 5.9%, p = 0.645). The T- or V-stent technique was an independent predictor of TLF in multivariate analysis (hazard ratio, 3.592; 95% confidence interval, 2.117-6.095; p < 0.001). Chronic kidney disease, reduced left ventricular ejection fraction, and left main bifurcation were independent predictors of TLF in patients with DM.

Conclusion:
T- or V-stenting in patients with DM resulted in increased cardiovascular events after second-generation DES implantation.

Clinical trial registration:
https://clinicaltrials.gov/ct2/show/NCT03068494?term=03068494&draw=2&rank=1, identifier: NCT03068494.
Keimyung Author(s)(Kor)
허승호
남창욱
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
2297-055X
Source
https://www.frontiersin.org/articles/10.3389/fcvm.2022.1018802/full
DOI
10.3389/fcvm.2022.1018802
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/44755
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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