title: Clinical and angiographic outcomes with sirolimus-eluting stent for coronary bifurcation lesions. The J-PMS study.
abstract: BACKGROUND
  Long-term outcomes of patients with bifurcated lesions and the restenotic response of the side branches after sirolimus-eluting stent (SES) implantation, comparing 1-stent with 2-stent treatment, are still under discussion.
  
  
  RESULTS
  Japan Post-Marketing Surveillance Registry (J-PMS) is a prospective registry designed to evaluate the safety and efficacy of the SES in routine clinical practice. Angiograms of 1,063 patients with 1,250 lesions were analyzed at the independent core lab. Of these, 324 patients with bifurcation lesions were enrolled. Clinical endpoints were assessed at 3 years. Both main and side branches were evaluated by quantitative coronary angiography at post-procedure (n=349) and 8-month follow up (n=293). Two-stent treatment was performed in 12% of the cases. In-segment restenosis rates at 8 months were 25.6% in the side branch, but newly developed restenosis was seen in only 6.8%. Late loss at the carina of the side branch was -0.11mm in the 1-stent group. Major adverse cardiovascular events rate was 18.3% at 3 years. Target-lesion revascularization rate up to 3 years was 21.6% in the 2-stent group and 8.7% in the 1-stent group (P=0.037). Stent thrombosis occurred in 6 cases (2.0%) until 3 years. Of these, 4 cases were treated with 2-stent (10.81% vs. 0.76% in 1-stent, P=0.003, respectively).
  
  
  CONCLUSIONS
  In a real-world setting, treatment of coronary bifurcation lesions using SES demonstrated favorable long-term outcomes as long as the side branch was not stented.
authors.affiliation: Teikyo University Hospital, Tokyo, Japan. PXE00364@nifty.com
authors.forename: Ken
authors.initials: K
authors.lastname: Kozuma
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Ota
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Nagai
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Katsuta
authors.forename: Eiji
authors.initials: E
authors.lastname: Nozaki
authors.forename: Tomoya
authors.initials: T
authors.lastname: Onodera
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
authors.forename: Junichi
authors.initials: J
authors.lastname: Kotani
authors.forename: Eisho
authors.initials: E
authors.lastname: Kyo
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Yokoi
authors.forename: Masato
authors.initials: M
authors.lastname: Nakamura
mesh_terms: D017130:Angioplasty / Q000295:instrumentation*; D001241:Aspirin / Q000008:administration & dosage / Q000627:therapeutic use; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D023921:Coronary Stenosis / Q000628:therapy*; D003328:Coronary Thrombosis / Q000453:epidemiology / Q000517:prevention & control; D003331:Coronary Vessels / Q000473:pathology; D054855:Drug-Eluting Stents; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D009203:Myocardial Infarction / Q000453:epidemiology / Q000517:prevention & control; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011358:Product Surveillance, Postmarketing; D020123:Sirolimus / Q000008:administration & dosage / Q000627:therapeutic use*; D016019:Survival Analysis; D019851:Thrombophilia / Q000188:drug therapy; D013988:Ticlopidine / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine; D001241:Aspirin; D020123:Sirolimus