title: An angiographic tool for risk prediction of side branch occlusion in coronary bifurcation intervention: the RESOLVE score system (Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion).
abstract: OBJECTIVE
  The purpose of this study was to establish a scoring system to evaluate the risk of side branch (SB) occlusion in patients undergoing coronary bifurcation intervention.
  
  
  BACKGROUND
  The risk of SB occlusion is the most important consideration affecting the selection of an optimal intervention strategy.
  
  
  METHODS
  A total of 1,545 consecutive patients undergoing percutaneous coronary intervention for bifurcation lesions (1,601 lesions treated with a single stent technique or main vessel [MV] stenting first strategy) were studied. A total of 1,200 lesions were used to construct the risk model and score system, and 401 lesions were used to validate the model. A multivariable risk score (RESOLVE [Risk prEdiction of Side branch OccLusion in coronary bifurcation interVEntion]) was constructed with incremental weights attributed to each component variable according to its estimated coefficients. SB occlusion after MV stenting was defined as any decrease in Thrombolysis in Myocardial Infarction flow grade or absence of flow in SB after MV stenting.
  
  
  RESULTS
  SB occlusion occurred in 118 (7.37%) of 1,601 bifurcation lesions. In multivariable analyses, 6 variables were independently associated with the risk of SB occlusion (model C-statistic = 0.80 [95% confidence interval: 0.75 to 0.85] with good calibration). For the 401 lesions included in the validation cohort, the RESOLVE score had a C-statistic of 0.77 (95% confidence interval: 0.69 to 0.86), with good calibration. SB occlusion rates in the validation cohort increased significantly across different risk groups, from 0.0% in the low-risk group, to 3.8% in the intermediate-risk group, and to 19.8% in the high-risk group (p < 0.001).
  
  
  CONCLUSIONS
  The RESOLVE score, a novel angiographic risk stratification tool, can help identify patients at risk for SB occlusion during bifurcation intervention.
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Kefei
authors.initials: K
authors.lastname: Dou
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: bxu@citmd.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Xu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China. Electronic address: yangyjfw@126.com.
authors.forename: Yuejin
authors.initials: Y
authors.lastname: Yang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Dong
authors.initials: D
authors.lastname: Yin
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Shubin
authors.initials: S
authors.lastname: Qiao
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Yongjian
authors.initials: Y
authors.lastname: Wu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Hongbing
authors.initials: H
authors.lastname: Yan
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Shijie
authors.initials: S
authors.lastname: You
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Zhenqiang
authors.initials: Z
authors.lastname: Wu
authors.affiliation: State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, and National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.
authors.forename: Runlin
authors.initials: R
authors.lastname: Gao
authors.affiliation: Columbia University Medical Center/New York Presbyterian Hospital, New York, New York.
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
mesh_terms: D000368:Aged; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy*; D054059:Coronary Occlusion / Q000209:etiology*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation; D011237:Predictive Value of Tests; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D018570:Risk Assessment; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
keywords: coronary bifurcation lesion; intervention strategy; risk prediction; score system; side branch occlusion