caa a22 4500 606221107 CHVBK 20210128101127.0 cr unu---uuuuu 210128e20150701xx s 000 0 eng 10.1007/s00380-014-0500-0 doi (NATIONALLICENCE)springer-10.1007/s00380-014-0500-0 Triple versus dual antiplatelet therapy after percutaneous coronary intervention for coronary bifurcation lesions: results from the COBIS (COronary BIfurcation Stent) II Registry [Elektronische Daten] [Pil Song, Young Song, Jeong Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Lee, Hyo-Soo Kim, Yangsoo Jang, Ki Seung, Ju Oh, Hyeon-Cheol Gwon] The efficacy and safety of adding cilostazol to aspirin plus clopidogrel (triple antiplatelet therapy, TAPT) have not been fully evaluated in complex percutaneous coronary intervention (PCI). We sought to investigate whether TAPT after PCI for bifurcation lesions improves long-term clinical outcomes. Consecutive patients undergoing PCI for bifurcation lesions were enrolled from 18 centers in Korea between 2003 and 2009. We compared target vessel failure (TVF), defined as a composite of cardiac death, myocardial infarction (MI), and target vessel revascularization (TVR), among 675 patients who received TAPT and 2081 who received dual antiplatelet therapy (DAPT: aspirin plus clopidogrel). Patients who received TAPT had more cardiovascular co-morbidities with regard to clinical, angiographic, and procedural characteristics. During the follow-up (median 36months), 346 (12.6%) TVFs occurred. The incidence of TVF was significantly higher in the TAPT group, mainly driven by a higher TVR rate. In the TAPT group, however, the risk of TVF was not significantly different from the DAPT group after adjusting for the confounders of TVFs (adjusted hazard ratio [HR] 0.86, 95% confidence interval [CI] 0.53-1.39, p=0.53). And also, there were no significant differences between the 2 groups in terms of the risks for death, cardiac death, MI, TVR, stent thrombosis, or cerebrovascular accident. These results were consistent after propensity score-matched analysis, and were also constant among the high-risk subgroups. TAPT after bifurcation PCI had no beneficial effect on the risk of long-term clinical outcomes in real-world clinical practice. Further studies are needed to confirm these findings. Springer Japan, 2014 Antiplatelet therapy nationallicence Percutaneous coronary intervention nationallicence Coronary bifurcation lesions nationallicence Song Pil Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea aut Song Young Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Yang Jeong Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Hahn Joo-Yong Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Choi Seung-Hyuk Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Choi Jin-Ho Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Lee Sang Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Kim Hyo-Soo Seoul National University Hospital, Seoul, Republic of Korea aut Jang Yangsoo Yonsei University Severance Hospital, Seoul, Republic of Korea aut Seung Ki Catholic University Kangnam St. Mary's Hospital, Seoul, Republic of Korea aut Oh Ju Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea aut Gwon Hyeon-Cheol Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut Heart and Vessels Springer Japan 30/4(2015-07-01), 458-468 0910-8327 30:4<458 2015 30 380 https://doi.org/10.1007/s00380-014-0500-0 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00380-014-0500-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Song Pil Division of Cardiology, Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Republic of Korea aut NATIONALLICENCE 700 1- Song Young Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Yang Jeong Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Hahn Joo-Yong Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Choi Seung-Hyuk Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Choi Jin-Ho Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Lee Sang Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Kim Hyo-Soo Seoul National University Hospital, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Jang Yangsoo Yonsei University Severance Hospital, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Seung Ki Catholic University Kangnam St. Mary's Hospital, Seoul, Republic of Korea aut NATIONALLICENCE 700 1- Oh Ju Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea aut NATIONALLICENCE 700 1- Gwon Hyeon-Cheol Division of Cardiology, Department of Medicine, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, #50, Irwon-dong, Gangnam-gu, 135-710, Seoul, Republic of Korea aut NATIONALLICENCE 773 0- Heart and Vessels Springer Japan 30/4(2015-07-01), 458-468 0910-8327 30:4<458 2015 30 380