title: Long-Term Clinical Outcomes of True and Non-True Bifurcation Lesions According to Medina Classification- Results From the COBIS (COronary BIfurcation Stent) II Registry.
abstract: BACKGROUND
  Little is known about the clinical outcomes of patients with different types of coronary bifurcation lesions. We sought to compare long-term clinical outcomes of patients with true or non-true bifurcation lesions who underwent percutaneous coronary intervention.
  
  
  RESULTS
  We compared major adverse cardiac events (MACE: cardiac death, myocardial infarction [MI], or target lesion revascularization) between 1,502 patients with true bifurcation lesions (51.8%) and 1,395 with non-true bifurcation lesions (48.2%). True bifurcation lesions were defined as Medina classification (1.1.1), (1.0.1), or (0.1.1) lesions. During a median follow-up of 36 months, MACE occurred in 296 (10.2%) patients. Patients with true bifurcation lesions had a significantly higher risk of MACE than those with non-true bifurcation lesions (HR 1.39; 95% CI 1.08-1.80; P=0.01). Among true bifurcation lesions, Medina (1.1.1) and (0.1.1) were associated with a higher risk of cardiac death or MI than Medina (1.0.1) (HR 4.15; 95% CI 1.01-17.1; P=0.05). During the procedure, side branch occlusion occurred more frequently in Medina (1.1.1) and (1.0.1) than Medina (0.1.1) lesions (11.5% vs. 7.4%, P=0.03).
  
  
  CONCLUSIONS
  Patients with true bifurcation lesions had worse clinical outcomes than those with non-true bifurcation lesions. Procedural and long-term clinical outcomes differed according to the type of bifurcation lesion. These findings should be considered in future bifurcation studies.
authors.affiliation: Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine.
authors.forename: Taek Kyu
authors.initials: TK
authors.lastname: Park
authors.forename: Yong Hwan
authors.initials: YH
authors.lastname: Park
authors.forename: Young Bin
authors.initials: YB
authors.lastname: Song
authors.forename: Ju Hyeon
authors.initials: JH
authors.lastname: Oh
authors.forename: Woo Jung
authors.initials: WJ
authors.lastname: Chun
authors.forename: Gu Hyun
authors.initials: GH
authors.lastname: Kang
authors.forename: Woo Jin
authors.initials: WJ
authors.lastname: Jang
authors.forename: Joo-Yong
authors.initials: JY
authors.lastname: Hahn
authors.forename: Jeong Hoon
authors.initials: JH
authors.lastname: Yang
authors.forename: Seung-Hyuk
authors.initials: SH
authors.lastname: Choi
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Lee
authors.forename: Myung-Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Jae-Hwan
authors.initials: JH
authors.lastname: Lee
authors.forename: Cheol Woong
authors.initials: CW
authors.lastname: Yu
authors.forename: Seung Woon
authors.initials: SW
authors.lastname: Rha
authors.forename: Yangsoo
authors.initials: Y
authors.lastname: Jang
authors.forename: Jung Han
authors.initials: JH
authors.lastname: Yoon
authors.forename: Seung-Jea
authors.initials: SJ
authors.lastname: Tahk
authors.forename: Ki Bae
authors.initials: KB
authors.lastname: Seung
authors.forename: Jong-Seon
authors.initials: JS
authors.lastname: Park
authors.forename: Hyeon-Cheol
authors.initials: HC
authors.lastname: Gwon
mesh_terms: D000368:Aged; D003643:Death; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications / Q000401:mortality*; D012042:Registries