Triple versus dual antiplatelet therapy after percutaneous coronary intervention for coronary bifurcation lesions: results from the COBIS (COronary BIfurcation Stent) II Registry

2014 ◽  
Vol 30 (4) ◽  
pp. 458-468 ◽  
Author(s):  
Pil Sang Song ◽  
Young Bin Song ◽  
Jeong Hoon Yang ◽  
Joo-Yong Hahn ◽  
Seung-Hyuk Choi ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Antiplatelet Therapy ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Coronary Bifurcation ◽  
Coronary Bifurcation Lesions ◽  
Percutaneous Coronary ◽  
Bifurcation Stent ◽  
Bifurcation Lesions

scholarly journals Carina Bifurcation Angle and Side Branch Occlusion in Coronary Bifurcation Lesions Intervention: Angiographic Lesions Characteristic Role in Determining Its Relation

2018 ◽  
Vol 28 (02) ◽  
pp. 137-141 ◽  
Author(s):  
Bogie Putra Palinggi ◽  
Doni Firman
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Side Branch ◽  
Coronary Bifurcation ◽  
Cross Sectional ◽  
Bifurcation Angle ◽  
Coronary Bifurcation Lesions ◽  
Increased Risk ◽  
Percutaneous Coronary ◽  
Bifurcation Lesions

AbstractSide branch occlusion has been implicated as a complication after percutaneous coronary intervention in coronary bifurcation lesions. The role of carina bifurcation angle as one of the characteristics of the coronary bifurcation lesions in causing side branch occlusion after percutaneous coronary intervention is still debated. This study aims to assess the correlation between carina bifurcation angles as one of the characteristics of the coronary bifurcation lesions and side branch occlusion in elective percutaneous coronary intervention. This is a cross-sectional study which utilizes CAAS 5.1 software to measure carina bifurcation angle. We collected 113 lesions in 108 patients that met the inclusion criteria from January 2016 to October 2016. Side branch occlusion occurred in 15 lesions (13.3%), with median carina bifurcation angle 19.17 degrees (p < 0.001). Multivariate analysis showed there is a correlation between carina bifurcation angle with side branch occlusion, OR (odds ratio) 0.86 (95% CI [confidence interval]: 0.80–0.92) with ≤ 33.71 degrees cut off value. Increased risk of side branch occlusion was found in small carina bifurcation angle.

scholarly journals Impact of atrial fibrillation on long-term outcomes in patients with coronary artery bifurcation lesions undergoing percutaneous coronary intervention

2021 ◽  
Vol 25 (4) ◽  
pp. 85
Author(s):  
D. A. Khelimskii ◽  
O. V. Krestyaninov ◽  
A. G. Badoian ◽  
A. A. Baranov ◽  
R. B. Utegenov ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Percutaneous Coronary Intervention ◽  
Cardiovascular Events ◽  
Coronary Intervention ◽  
Major Adverse Cardiovascular Events ◽  
Coronary Bifurcation ◽  
Coronary Bifurcation Lesions ◽  
Percutaneous Coronary ◽  
Bifurcation Lesions

<p><strong>Background.</strong> Atrial fibrillation is one of the most common types of cardiac arrhythmias. The frequent combination of atrial fibrillation and coronary artery disease in clinical practice can be attributed to common risk factors and relationships among pathogenetic mechanisms.</p><p><strong>Aim. </strong>This study aims to evaluate the impact of atrial fibrillation on immediate and long-term clinical outcomes in patients undergoing percutaneous coronary intervention for coronary bifurcation lesions.</p><p><strong>Methods.</strong> This study included 709 patients who underwent percutaneous coronary intervention for coronary bifurcation lesions. All patients were divided into two groups: those with and without atrial fibrillation.</p><p><strong>Results.</strong> This multicentre registry showed that the incidence of atrial fibrillation was 11.7%. Compared to patients without a history of atrial fibrillation, those that did were older (66.8 ± 8.5 vs. 62.9 ± 9.0 years, p = 0.0002) and more often had cerebrovascular (22.9% vs. 10.4%, p = 0.003) and peripheral artery disease (18.1% vs. 7.2%, p = 0.002). The overall incidence of major adverse cardiovascular events at the hospital stage was 1.8%. The average follow-up duration was 476 ± 94 days. No difference in long-term major adverse cardiovascular events (15.0% vs. 13.1%, p = 0.6) was observed between patients with and without atrial fibrillation. Patients with atrial fibrillation were more likely to have adverse events, such as bleeding (13.8% vs. 9.3%, p = 0.22), stroke (2.5% vs. 1.0%, p = 0.23) and myocardial infarction (7.6% vs. 5.0%, p = 0.28), although differences between the groups were insignificant.</p><p><strong>Conclusion.</strong> Atrial fibrillation was not associated with mortality and major adverse cardiovascular events in patients undergoing percutaneous coronary intervention for coronary bifurcation lesions.</p><p><strong>ClinicalTrials.gov Identifier: </strong>NCT03450577</p><p>Received 4 August 2021. Revised 27 September 2021. Accepted 28 September 2021.</p><p><strong>Funding: </strong>The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Contribution of the authors<br /> </strong>Conception and study design: D.A. Khelimskii, O.V. Krestyaninov, A.G. Badoian, A.A. Baranov, R.B. Utegenov, I.S. Bessonov, S.S. Sapozhnikov<br /> Data collection and analysis: D.A. Khelimskii, A.G. Badoian, A.A. Baranov, R.B. Utegenov, I.S. Bessonov, S.S. Sapozhnikov<br /> Statistical analysis: D.A. Khelimskii, A.G. Badoian, I.S. Bessonov<br /> Drafting the article: D.A. Khelimskii, O.V. Krestyaninov, A.G. Badoian, A.A. Baranov, R.B. Utegenov, I.S. Bessonov, S.S. Sapozhnikov<br /> Critical revision of the article: D.A. Khelimskii, O.V. Krestyaninov, A.G. Badoian, A.A. Baranov, R.B. Utegenov, I.S. Bessonov, S.S. Sapozhnikov<br /> Final approval of the version to be published: D.A. Khelimskii, O.V. Krestyaninov, A.G. Badoian, A.A. Baranov, R.B. Utegenov, I.S. Bessonov, S.S. Sapozhnikov</p>

scholarly journals Benefit of Prolonged Dual Antiplatelet Therapy After Implantation of Drug-Eluting Stent for Coronary Bifurcation Lesions

2018 ◽  
Vol 11 (7) ◽  
Author(s):  
Woo Jin Jang ◽  
Sung Gyun Ahn ◽  
Young Bin Song ◽  
Seung-Hyuk Choi ◽  
Woo Jung Chun ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Confidence Interval ◽  
Dual Antiplatelet Therapy ◽  
Coronary Intervention ◽  
Drug Eluting Stent ◽  
Coronary Bifurcation ◽  
Index Procedure ◽  
Percutaneous Coronary ◽  
Drug Eluting ◽  
Bifurcation Lesions

Background: Whether prolonged dual antiplatelet therapy (DAPT) improves clinical outcomes after percutaneous coronary intervention for coronary bifurcation lesion is uncertain. Methods and Results: We evaluated 2082 patients who were treated with drug-eluting stent for bifurcation lesions and were event free (no death, myocardial infarction [MI], cerebrovascular accident, stent thrombosis, or any revascularization) at 12 months after the index procedure. Patients were divided into 2 groups: DAPT ≥12-month group (n=1776) and DAPT <12-month group (n=306). Primary outcome was all-cause death or MI. At 4 years after the index procedure, death or MI occurred less frequently in the DAPT ≥12-month group than the DAPT <12-month group (2.8% versus 12.3%; adjusted hazard ratio, 0.21; 95% confidence interval, 0.13–0.35; P <0.001). After propensity score matching, incidence of death or MI was still lower in the DAPT ≥12-month group than the DAPT <12-month group (2.6% versus 12.3%; adjusted hazard ratio, 0.22; 95% confidence interval, 0.12–0.38; P <0.001). In subgroup analysis, the treatment effect of prolonged DAPT was consistent across subgroups regardless of lesion location, stenting technique, or type of used drug-eluting stent. Conclusions: The risk of all-cause death or MI was significantly lower in the ≥12-month DAPT group than the <12-month DAPT group after percutaneous coronary intervention for bifurcation lesion using drug-eluting stent. Our results suggest that prolonged DAPT may improve long-term clinical outcomes after percutaneous coronary intervention for bifurcation lesions. Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01642992

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