Immediate and one-year outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry)

Balloon angioplasty of bifurcation lesions has been associated with lower success and higher complication rates than most other lesion types. The development of alternative strategies such as debulking and stenting, either alone or in combination, are currently used relatively often. The relative ro...

Full description

Saved in:
Bibliographic Details
Published in:The American journal of cardiology 2001-05, Vol.87 (10), p.1139-1144
Main Authors: Al Suwaidi, Jassim, Yeh, Wanlin, Cohen, Howard A, Detre, Katherine M, Williams, David O, Holmes, David R
Format: Article
Language:English
Subjects:
Aged
Angioplasty
Angioplasty, Balloon, Coronary - adverse effects
Atherectomy, Coronary - adverse effects
Biological and medical sciences
Cardiology. Vascular system
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Coronary Artery Disease - pathology
Coronary Artery Disease - therapy
Coronary heart disease
Coronary vessels
Coronary Vessels - pathology
Female
Heart
Humans
Male
Medical research
Medical sciences
Medical technology
Middle Aged
Multivariate Analysis
Odds Ratio
Outcome Assessment (Health Care)
Stents - adverse effects
Survival Rate
Treatment Outcome
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273
cites cdi_FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273
container_end_page 1144
container_issue 10
container_start_page 1139
container_title The American journal of cardiology
container_volume 87
creator Al Suwaidi, Jassim
Yeh, Wanlin
Cohen, Howard A
Detre, Katherine M
Williams, David O
Holmes, David R
description Balloon angioplasty of bifurcation lesions has been associated with lower success and higher complication rates than most other lesion types. The development of alternative strategies such as debulking and stenting, either alone or in combination, are currently used relatively often. The relative role of these newer approaches in improving acute or long-term outcome, however, remains uncertain. Of the total of 2,436 patients treated between July 1997 to February 1998 in the National Heart, Lung, and Blood Institute Dynamic Registry, there were 321 patients (group 1) with bifurcation lesions and 2,115 patients without any bifurcation lesions attempted (group 2). Treatment strategies in terms of major devices used were significantly different between the 2 groups (group 1 vs 2): balloon angioplasty alone (23.1% vs 26.5%), balloon angioplasty and rotational atherectomy (6.9% vs 4.4%), balloon angioplasty and stent (55.8% vs 59.9%), and balloon angioplasty, rotational atherectomy, and stent (10.3% vs 7%) with p
doi_str_mv 10.1016/S0002-9149(01)01482-5
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_70846407</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0002914901014825</els_id><sourcerecordid>74068818</sourcerecordid><originalsourceid>FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273</originalsourceid><addsrcrecordid>eNqFkVFrFDEUhYModlv9CUpQKO3DaJLJZDNPokXtwqIP6nPIJDc2ZSZZk4xl_72Z7lLBF58uId89nHsOQi8oeUMJFW-_EUJY01PeXxB6SSiXrOkeoRWV676hPW0fo9UDcoJOc76tT0o78RSdUNp2opVihe420wTW6wJYB4tjgGYPOuE4FxMnwD7gnS4eQsn4zpcbbGKKQac9Hrybk6l_MeARch15ocsN4ClaSAFD0vjiy_X2wwbbfdCTNzjBT59L2l8-Q0-cHjM8P84z9OPTx-9X18326-fN1fttYzgVpWGuY47LgbPegQPbg6VadlwbZq0UgkjuOkoGvpaCtbw3nXTA9WBpPVaydXuGzg-6uxR_zZCLmnw2MI46QJyzWlcFwckCvvoHvI1zCtWbYi1pBVmzrkLdATIp5pzAqV3yU01DUaKWWtR9LWrJXBGq7mtRy97Lo_g81Lj_bh17qMDrI6Cz0aNLOhifH7i-nkwXj-8OFNTEfntIKptajakFJjBF2ej_Y-QPFzCo0A</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>230360725</pqid></control><display><type>article</type><title>Immediate and one-year outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry)</title><source>ScienceDirect Freedom Collection 2022-2024</source><creator>Al Suwaidi, Jassim ; Yeh, Wanlin ; Cohen, Howard A ; Detre, Katherine M ; Williams, David O ; Holmes, David R</creator><creatorcontrib>Al Suwaidi, Jassim ; Yeh, Wanlin ; Cohen, Howard A ; Detre, Katherine M ; Williams, David O ; Holmes, David R</creatorcontrib><description>Balloon angioplasty of bifurcation lesions has been associated with lower success and higher complication rates than most other lesion types. The development of alternative strategies such as debulking and stenting, either alone or in combination, are currently used relatively often. The relative role of these newer approaches in improving acute or long-term outcome, however, remains uncertain. Of the total of 2,436 patients treated between July 1997 to February 1998 in the National Heart, Lung, and Blood Institute Dynamic Registry, there were 321 patients (group 1) with bifurcation lesions and 2,115 patients without any bifurcation lesions attempted (group 2). Treatment strategies in terms of major devices used were significantly different between the 2 groups (group 1 vs 2): balloon angioplasty alone (23.1% vs 26.5%), balloon angioplasty and rotational atherectomy (6.9% vs 4.4%), balloon angioplasty and stent (55.8% vs 59.9%), and balloon angioplasty, rotational atherectomy, and stent (10.3% vs 7%) with p &lt;0.01. There were no significant differences between the groups in terms of age, gender, and frequency of prior myocardial infarction (MI) or coronary artery bypass graft surgery (CABG). Complete angiographic success was achieved in only 86% of bifurcation lesions versus 93.5% of nonbifurcation lesions (p &lt;0.001). In-hospital complication rates were increased in patients with bifurcation lesions compared with the nonbifurcation group: MI, 3.7% versus 2.6%; CABG, 2.2% versus 1.1%; side branch occlusion, 7.3% versus 2.3% (p &lt;0.001); and the composite of death, MI, and any CABG, 7.2% versus 5.0%. At 1-year follow-up, major adverse cardiac events were 25% higher in group 1 than in group 2 (32.1% vs 25.7%, p &lt;0.05). We conclude that despite the widespread use of newer percutaneous devices, treatment of bifurcation lesions remains difficult and is associated with decreased success and increased complication rates compared with nonbifurcation lesions.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/S0002-9149(01)01482-5</identifier><identifier>PMID: 11356386</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Angioplasty ; Angioplasty, Balloon, Coronary - adverse effects ; Atherectomy, Coronary - adverse effects ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary Angiography ; Coronary Artery Bypass ; Coronary Artery Disease - diagnostic imaging ; Coronary Artery Disease - mortality ; Coronary Artery Disease - pathology ; Coronary Artery Disease - therapy ; Coronary heart disease ; Coronary vessels ; Coronary Vessels - pathology ; Female ; Heart ; Humans ; Male ; Medical research ; Medical sciences ; Medical technology ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Outcome Assessment (Health Care) ; Stents - adverse effects ; Survival Rate ; Treatment Outcome</subject><ispartof>The American journal of cardiology, 2001-05, Vol.87 (10), p.1139-1144</ispartof><rights>2001 Excerpta Medica Inc.</rights><rights>2001 INIST-CNRS</rights><rights>Copyright Elsevier Sequoia S.A. May 15, 2001</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273</citedby><cites>FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&amp;idt=985417$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11356386$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Al Suwaidi, Jassim</creatorcontrib><creatorcontrib>Yeh, Wanlin</creatorcontrib><creatorcontrib>Cohen, Howard A</creatorcontrib><creatorcontrib>Detre, Katherine M</creatorcontrib><creatorcontrib>Williams, David O</creatorcontrib><creatorcontrib>Holmes, David R</creatorcontrib><title>Immediate and one-year outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Balloon angioplasty of bifurcation lesions has been associated with lower success and higher complication rates than most other lesion types. The development of alternative strategies such as debulking and stenting, either alone or in combination, are currently used relatively often. The relative role of these newer approaches in improving acute or long-term outcome, however, remains uncertain. Of the total of 2,436 patients treated between July 1997 to February 1998 in the National Heart, Lung, and Blood Institute Dynamic Registry, there were 321 patients (group 1) with bifurcation lesions and 2,115 patients without any bifurcation lesions attempted (group 2). Treatment strategies in terms of major devices used were significantly different between the 2 groups (group 1 vs 2): balloon angioplasty alone (23.1% vs 26.5%), balloon angioplasty and rotational atherectomy (6.9% vs 4.4%), balloon angioplasty and stent (55.8% vs 59.9%), and balloon angioplasty, rotational atherectomy, and stent (10.3% vs 7%) with p &lt;0.01. There were no significant differences between the groups in terms of age, gender, and frequency of prior myocardial infarction (MI) or coronary artery bypass graft surgery (CABG). Complete angiographic success was achieved in only 86% of bifurcation lesions versus 93.5% of nonbifurcation lesions (p &lt;0.001). In-hospital complication rates were increased in patients with bifurcation lesions compared with the nonbifurcation group: MI, 3.7% versus 2.6%; CABG, 2.2% versus 1.1%; side branch occlusion, 7.3% versus 2.3% (p &lt;0.001); and the composite of death, MI, and any CABG, 7.2% versus 5.0%. At 1-year follow-up, major adverse cardiac events were 25% higher in group 1 than in group 2 (32.1% vs 25.7%, p &lt;0.05). We conclude that despite the widespread use of newer percutaneous devices, treatment of bifurcation lesions remains difficult and is associated with decreased success and increased complication rates compared with nonbifurcation lesions.</description><subject>Aged</subject><subject>Angioplasty</subject><subject>Angioplasty, Balloon, Coronary - adverse effects</subject><subject>Atherectomy, Coronary - adverse effects</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Bypass</subject><subject>Coronary Artery Disease - diagnostic imaging</subject><subject>Coronary Artery Disease - mortality</subject><subject>Coronary Artery Disease - pathology</subject><subject>Coronary Artery Disease - therapy</subject><subject>Coronary heart disease</subject><subject>Coronary vessels</subject><subject>Coronary Vessels - pathology</subject><subject>Female</subject><subject>Heart</subject><subject>Humans</subject><subject>Male</subject><subject>Medical research</subject><subject>Medical sciences</subject><subject>Medical technology</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Odds Ratio</subject><subject>Outcome Assessment (Health Care)</subject><subject>Stents - adverse effects</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0002-9149</issn><issn>1879-1913</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2001</creationdate><recordtype>article</recordtype><recordid>eNqFkVFrFDEUhYModlv9CUpQKO3DaJLJZDNPokXtwqIP6nPIJDc2ZSZZk4xl_72Z7lLBF58uId89nHsOQi8oeUMJFW-_EUJY01PeXxB6SSiXrOkeoRWV676hPW0fo9UDcoJOc76tT0o78RSdUNp2opVihe420wTW6wJYB4tjgGYPOuE4FxMnwD7gnS4eQsn4zpcbbGKKQac9Hrybk6l_MeARch15ocsN4ClaSAFD0vjiy_X2wwbbfdCTNzjBT59L2l8-Q0-cHjM8P84z9OPTx-9X18326-fN1fttYzgVpWGuY47LgbPegQPbg6VadlwbZq0UgkjuOkoGvpaCtbw3nXTA9WBpPVaydXuGzg-6uxR_zZCLmnw2MI46QJyzWlcFwckCvvoHvI1zCtWbYi1pBVmzrkLdATIp5pzAqV3yU01DUaKWWtR9LWrJXBGq7mtRy97Lo_g81Lj_bh17qMDrI6Cz0aNLOhifH7i-nkwXj-8OFNTEfntIKptajakFJjBF2ej_Y-QPFzCo0A</recordid><startdate>20010515</startdate><enddate>20010515</enddate><creator>Al Suwaidi, Jassim</creator><creator>Yeh, Wanlin</creator><creator>Cohen, Howard A</creator><creator>Detre, Katherine M</creator><creator>Williams, David O</creator><creator>Holmes, David R</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>8FD</scope><scope>FR3</scope><scope>K9.</scope><scope>M7Z</scope><scope>NAPCQ</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20010515</creationdate><title>Immediate and one-year outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry)</title><author>Al Suwaidi, Jassim ; Yeh, Wanlin ; Cohen, Howard A ; Detre, Katherine M ; Williams, David O ; Holmes, David R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2001</creationdate><topic>Aged</topic><topic>Angioplasty</topic><topic>Angioplasty, Balloon, Coronary - adverse effects</topic><topic>Atherectomy, Coronary - adverse effects</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Bypass</topic><topic>Coronary Artery Disease - diagnostic imaging</topic><topic>Coronary Artery Disease - mortality</topic><topic>Coronary Artery Disease - pathology</topic><topic>Coronary Artery Disease - therapy</topic><topic>Coronary heart disease</topic><topic>Coronary vessels</topic><topic>Coronary Vessels - pathology</topic><topic>Female</topic><topic>Heart</topic><topic>Humans</topic><topic>Male</topic><topic>Medical research</topic><topic>Medical sciences</topic><topic>Medical technology</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Odds Ratio</topic><topic>Outcome Assessment (Health Care)</topic><topic>Stents - adverse effects</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Al Suwaidi, Jassim</creatorcontrib><creatorcontrib>Yeh, Wanlin</creatorcontrib><creatorcontrib>Cohen, Howard A</creatorcontrib><creatorcontrib>Detre, Katherine M</creatorcontrib><creatorcontrib>Williams, David O</creatorcontrib><creatorcontrib>Holmes, David R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Biochemistry Abstracts 1</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Al Suwaidi, Jassim</au><au>Yeh, Wanlin</au><au>Cohen, Howard A</au><au>Detre, Katherine M</au><au>Williams, David O</au><au>Holmes, David R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Immediate and one-year outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry)</atitle><jtitle>The American journal of cardiology</jtitle><addtitle>Am J Cardiol</addtitle><date>2001-05-15</date><risdate>2001</risdate><volume>87</volume><issue>10</issue><spage>1139</spage><epage>1144</epage><pages>1139-1144</pages><issn>0002-9149</issn><eissn>1879-1913</eissn><coden>AJCDAG</coden><abstract>Balloon angioplasty of bifurcation lesions has been associated with lower success and higher complication rates than most other lesion types. The development of alternative strategies such as debulking and stenting, either alone or in combination, are currently used relatively often. The relative role of these newer approaches in improving acute or long-term outcome, however, remains uncertain. Of the total of 2,436 patients treated between July 1997 to February 1998 in the National Heart, Lung, and Blood Institute Dynamic Registry, there were 321 patients (group 1) with bifurcation lesions and 2,115 patients without any bifurcation lesions attempted (group 2). Treatment strategies in terms of major devices used were significantly different between the 2 groups (group 1 vs 2): balloon angioplasty alone (23.1% vs 26.5%), balloon angioplasty and rotational atherectomy (6.9% vs 4.4%), balloon angioplasty and stent (55.8% vs 59.9%), and balloon angioplasty, rotational atherectomy, and stent (10.3% vs 7%) with p &lt;0.01. There were no significant differences between the groups in terms of age, gender, and frequency of prior myocardial infarction (MI) or coronary artery bypass graft surgery (CABG). Complete angiographic success was achieved in only 86% of bifurcation lesions versus 93.5% of nonbifurcation lesions (p &lt;0.001). In-hospital complication rates were increased in patients with bifurcation lesions compared with the nonbifurcation group: MI, 3.7% versus 2.6%; CABG, 2.2% versus 1.1%; side branch occlusion, 7.3% versus 2.3% (p &lt;0.001); and the composite of death, MI, and any CABG, 7.2% versus 5.0%. At 1-year follow-up, major adverse cardiac events were 25% higher in group 1 than in group 2 (32.1% vs 25.7%, p &lt;0.05). We conclude that despite the widespread use of newer percutaneous devices, treatment of bifurcation lesions remains difficult and is associated with decreased success and increased complication rates compared with nonbifurcation lesions.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>11356386</pmid><doi>10.1016/S0002-9149(01)01482-5</doi><tpages>6</tpages></addata></record>
fulltext fulltext
identifier ISSN: 0002-9149
ispartof The American journal of cardiology, 2001-05, Vol.87 (10), p.1139-1144
issn 0002-9149
1879-1913
language eng
recordid cdi_proquest_miscellaneous_70846407
source ScienceDirect Freedom Collection 2022-2024
subjects Aged
Angioplasty
Angioplasty, Balloon, Coronary - adverse effects
Atherectomy, Coronary - adverse effects
Biological and medical sciences
Cardiology. Vascular system
Coronary Angiography
Coronary Artery Bypass
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Coronary Artery Disease - pathology
Coronary Artery Disease - therapy
Coronary heart disease
Coronary vessels
Coronary Vessels - pathology
Female
Heart
Humans
Male
Medical research
Medical sciences
Medical technology
Middle Aged
Multivariate Analysis
Odds Ratio
Outcome Assessment (Health Care)
Stents - adverse effects
Survival Rate
Treatment Outcome
title Immediate and one-year outcome in patients with coronary bifurcation lesions in the modern era (NHLBI dynamic registry)
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-12-26T21%3A55%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Immediate%20and%20one-year%20outcome%20in%20patients%20with%20coronary%20bifurcation%20lesions%20in%20the%20modern%20era%20(NHLBI%20dynamic%20registry)&rft.jtitle=The%20American%20journal%20of%20cardiology&rft.au=Al%20Suwaidi,%20Jassim&rft.date=2001-05-15&rft.volume=87&rft.issue=10&rft.spage=1139&rft.epage=1144&rft.pages=1139-1144&rft.issn=0002-9149&rft.eissn=1879-1913&rft.coden=AJCDAG&rft_id=info:doi/10.1016/S0002-9149(01)01482-5&rft_dat=%3Cproquest_cross%3E74068818%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c416t-2f52f48b429fefed9ed1a854ac2dd866084f510b47862349c58fe4abd10008273%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=230360725&rft_id=info:pmid/11356386&rfr_iscdi=true