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

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‐yea...

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Autores principales:	Joo Myung Lee, Seung Hun Lee, Juwon Kim, Ki Hong Choi, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Joo‐Yong Hahn, Jin‐Ho Choi, Seung‐Hyuk Choi, Hyo‐Soo Kim, Woo Jung Chun, Chang‐Wook Nam, Seung‐Ho Hur, Seung Hwan Han, Seung‐Woon Rha, In‐Ho Chae, Jin‐Ok Jeong, Jung Ho Heo, Junghan Yoon, Do‐Sun Lim, Jong‐Seon Park, Myeong‐Ki Hong, Joon‐Hyung Doh, Kwang Soo Cha, Doo‐Il Kim, Sang Yeub Lee, Kiyuk Chang, Byung‐Hee Hwang, So‐Yeon Choi, Myung Ho Jeong, Soon‐Jun Hong, Bon‐Kwon Koo, Hyeon‐Cheol Gwon
Formato:	article
Lenguaje:	EN
Publicado:	Wiley 2021
Materias:	clinical outcome coronary bifurcation lesion drug‐eluting stent percutaneous coronary intervention Diseases of the circulatory (Cardiovascular) system RC666-701
Acceso en línea:	https://doaj.org/article/99a257da708b4707920166d05af5debd
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spelling	oai:doaj.org-article:99a257da708b4707920166d05af5debd2021-11-23T11:36:35ZTen‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques10.1161/JAHA.121.0216322047-9980https://doaj.org/article/99a257da708b4707920166d05af5debd2021-09-01T00:00:00Zhttps://www.ahajournals.org/doi/10.1161/JAHA.121.021632https://doaj.org/toc/2047-9980Background 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. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT01642992 and NCT03068494.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 GwonWileyarticleclinical outcomecoronary bifurcation lesiondrug‐eluting stentpercutaneous coronary interventionDiseases of the circulatory (Cardiovascular) systemRC666-701ENJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease, Vol 10, Iss 18 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	clinical outcome coronary bifurcation lesion drug‐eluting stent percutaneous coronary intervention Diseases of the circulatory (Cardiovascular) system RC666-701
spellingShingle	clinical outcome coronary bifurcation lesion drug‐eluting stent percutaneous coronary intervention Diseases of the circulatory (Cardiovascular) system RC666-701 Joo Myung Lee Seung Hun Lee Juwon Kim Ki Hong Choi Taek Kyu Park Jeong Hoon Yang Young Bin Song Joo‐Yong Hahn Jin‐Ho Choi Seung‐Hyuk Choi Hyo‐Soo Kim Woo Jung Chun Chang‐Wook Nam Seung‐Ho Hur Seung Hwan Han Seung‐Woon Rha In‐Ho Chae Jin‐Ok Jeong Jung Ho Heo Junghan Yoon Do‐Sun Lim Jong‐Seon Park Myeong‐Ki Hong Joon‐Hyung Doh Kwang Soo Cha Doo‐Il Kim Sang Yeub Lee Kiyuk Chang Byung‐Hee Hwang So‐Yeon Choi Myung Ho Jeong Soon‐Jun Hong Bon‐Kwon Koo Hyeon‐Cheol Gwon Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques
description	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. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT01642992 and NCT03068494.
format	article
author	Joo Myung Lee Seung Hun Lee Juwon Kim Ki Hong Choi Taek Kyu Park Jeong Hoon Yang Young Bin Song Joo‐Yong Hahn Jin‐Ho Choi Seung‐Hyuk Choi Hyo‐Soo Kim Woo Jung Chun Chang‐Wook Nam Seung‐Ho Hur Seung Hwan Han Seung‐Woon Rha In‐Ho Chae Jin‐Ok Jeong Jung Ho Heo Junghan Yoon Do‐Sun Lim Jong‐Seon Park Myeong‐Ki Hong Joon‐Hyung Doh Kwang Soo Cha Doo‐Il Kim Sang Yeub Lee Kiyuk Chang Byung‐Hee Hwang So‐Yeon Choi Myung Ho Jeong Soon‐Jun Hong Bon‐Kwon Koo Hyeon‐Cheol Gwon
author_facet	Joo Myung Lee Seung Hun Lee Juwon Kim Ki Hong Choi Taek Kyu Park Jeong Hoon Yang Young Bin Song Joo‐Yong Hahn Jin‐Ho Choi Seung‐Hyuk Choi Hyo‐Soo Kim Woo Jung Chun Chang‐Wook Nam Seung‐Ho Hur Seung Hwan Han Seung‐Woon Rha In‐Ho Chae Jin‐Ok Jeong Jung Ho Heo Junghan Yoon Do‐Sun Lim Jong‐Seon Park Myeong‐Ki Hong Joon‐Hyung Doh Kwang Soo Cha Doo‐Il Kim Sang Yeub Lee Kiyuk Chang Byung‐Hee Hwang So‐Yeon Choi Myung Ho Jeong Soon‐Jun Hong Bon‐Kwon Koo Hyeon‐Cheol Gwon
author_sort	Joo Myung Lee
title	Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques
title_short	Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques
title_full	Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques
title_fullStr	Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques
title_full_unstemmed	Ten‐Year Trends in Coronary Bifurcation Percutaneous Coronary Intervention: Prognostic Effects of Patient and Lesion Characteristics, Devices, and Techniques
title_sort	ten‐year trends in coronary bifurcation percutaneous coronary intervention: prognostic effects of patient and lesion characteristics, devices, and techniques
publisher	Wiley
publishDate	2021
url	https://doaj.org/article/99a257da708b4707920166d05af5debd
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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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