Author + information
- Received January 5, 2015
- Revision received March 25, 2015
- Accepted April 23, 2015
- Published online August 24, 2015.
- Cheol Woong Yu, MD∗,
- Jeong Hoon Yang, MD†,
- Young Bin Song, MD†,
- Joo-Yong Hahn, MD†,
- Seung-Hyuk Choi, MD†,
- Jin-Ho Choi, MD†,
- Hyun Jong Lee, MD‡,
- Ju Hyeon Oh, MD§,
- Bon-Kwon Koo, MD‖,
- Seung Woon Rha, MD¶,
- Jin-Ok Jeong, MD#,
- Myung-Ho Jeong, MD∗∗,
- Jung Han Yoon, MD††,
- Yangsoo Jang, MD‡‡,
- Seung-Jea Tahk, MD§§,
- Hyo-Soo Kim, MD‖ and
- Hyeon-Cheol Gwon, MD†∗ ()
- ∗Division of Cardiology, Cardiovascular Center, Korea University Anam Hospital, Seoul, Republic of Korea
- †Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- ‡Division of Cardiology, Sejong General Hospital, Bucheon, Republic of Korea
- §Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea
- ‖Seoul National University Hospital, Seoul, Republic of Korea
- ¶Korea University Guro Hospital, Seoul, Republic of Korea
- #Chungnam National University Hospital, Daejeon, Republic of Korea
- ∗∗Chonnam National University Hospital, Gwangju, Republic of Korea
- ††Division of Cardiology, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea
- ‡‡Yonsei University Severance Hospital, Seoul, Republic of Korea
- §§Ajou University Hospital, Suwon, Republic of Korea
- ↵∗Reprint requests and correspondence:
Dr. Hyeon-Cheol Gwon, Division of Cardiology, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
Objectives This study investigated the impact of final kissing ballooning (FKB) after main vessel (MV) stenting on outcomes in patients with coronary bifurcation lesions after application of the 1-stent technique.
Background Although FKB has been established as the standard method for bifurcation lesions treated with a 2-stent strategy, its efficacy in a 1-stent approach is highly controversial.
Methods This study enrolled 1,901 patients with a bifurcation lesion with a side branch diameter ≥2.3 mm, treated solely with the 1-stent technique using a drug-eluting stent from 18 centers in Korea between January 1, 2003 and December 31, 2009. The primary outcome was major adverse cardiac events (MACE)—cardiac death, myocardial infarction, or target lesion revascularization. Propensity score-matching analysis was also performed.
Results FKB was performed in 620 patients and the post minimal lumen diameter of the MV and side branch was larger in the FKB group than in the non-FKB group. During follow-up (median 36 months), the incidence of MACE (adjusted hazard ratio [HR]: 0.68, 95% confidence interval [CI]: 0.46 to 0.99; p = 0.048) was lower in the FKB group than the non-FKB group. After propensity score matching (545 pairs), the FKB group had a lower incidence of MACE (adjusted HR: 0.50, 95% CI: 0.30 to 0.85; p = 0.01), and target lesion revascularization in the MV (adjusted HR: 0.51, 95% CI: 0.28 to 0.93; p = 0.03) and both vessels (adjusted HR: 0.47, 95% CI: 0.25 to 0.90; p = 0.02) than in the non-FKB group.
Conclusions In coronary bifurcation lesions, we demonstrated that the 1-stent technique with FKB was associated with a favorable long-term clinical outcome, mainly driven by the reduction of target lesion revascularization in the MV or both vessels as a result of an increase in minimal lumen diameter. (Korean Coronary Bifurcation Stenting Registry II [COBIS II]: NCT01642992)
The authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Yu and Yang contributed equally to this study.
- Received January 5, 2015.
- Revision received March 25, 2015.
- Accepted April 23, 2015.
- 2015 American College of Cardiology Foundation