Impact of coronary bifurcation angle on clinical outcomes after percutaneous coronary intervention in real-world practice: results from the COBIS registry.
OBJECTIVE
Bifurcation angle has emerged as a predictor of outcome after percutaneous coronary intervention (PCI) for bifurcation lesions. We investigated the impact of bifurcation angle on clinical outcomes in patients undergoing bifurcation lesion PCI.


METHODS
Consecutive patients who received PCI for bifurcation lesions were enrolled from 16 centers in Korea between January 2004 and June 2006. Patients were divided into low-angle and high-angle groups using the median bifurcation angle (50°). We compared major adverse cardiac events, including cardiac death, myocardial infarction and target lesion revascularization as well as periprocedural outcomes between the 2 groups.


RESULTS
We evaluated 1,432 patients with bifurcation lesions with a median follow-up duration of 21 months. The rates of interventional side branch procedures such as guide-wiring of side branches, side-branch ballooning, final kissing ballooning and side-branch stenting were higher in the low-angle group. However, the incidences of major adverse cardiac events and target lesion revascularization were not significantly different between the 2 groups (6.6 vs. 6.9%, p = 0.856 and 4.6 vs. 5.7%, p = 0.375, respectively).


CONCLUSIONS
Bifurcation angle may not influence long-term clinical outcome in patients with non-left main bifurcation lesion undergoing PCI despite its association with more interventional side-branch procedures.
Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Jeong Hoon
JH
Yang
Young Bin
YB
Song
Pil Sang
PS
Song
Joo-Yong
JY
Hahn
Seung-Hyuk
SH
Choi
Jin-Ho
JH
Choi
Sang Hoon
SH
Lee
Hyo-Soo
HS
Kim
Yangsoo
Y
Jang
Seung-Jea
SJ
Tahk
Ki Bae
KB
Seung
Seung-Jung
SJ
Park
Hyeon-Cheol
HC
Gwon
D015906:Angioplasty, Balloon, Coronary / Q000379:methods* / Q000401:mortality; D017023:Coronary Angiography / Q000379:methods / Q000401:mortality; D023921:Coronary Stenosis / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D054855:Drug-Eluting Stents; D006801:Humans; D053208:Kaplan-Meier Estimate; D012042:Registries; D016896:Treatment Outcome