Evidence map›Paper›PMID 38076349›Full record

ArticleInternational journal of cardiology. Heart & vasculature2023

Impact of Medina classification on clinical outcomes of imaging-guided coronary bifurcation stenting.

Yoshinobu Murasato, Yoshihisa Kinoshita, Masahiro Yamawaki, Takayuki Okamura, Ryoji Nagoshi, Yusuke Watanabe, Nobuaki Suzuki, Takahiro Mori, Toshiro Shinke, Junya Shite and 1 more

Abstract read
In one paragraph

Article in International journal of cardiology. Heart & vasculature, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Coronary Bifurcation PCI-Part I: Fundamentals.Journal of cardiovascular development and disease · 2025
    Review
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Yoshinobu MurasatoDepartment of Cardiology & Clinical Research Centre, National Hospital Organization, Kyusyu Medical Centre, Fukuoka, Japan.
Yoshihisa KinoshitaDepartment of Cardiology, Toyohashi Heart Centre, Toyohashi, Japan.
Masahiro YamawakiDepartment of Cardiology, Saiseikai Yokohama City Eastern Hospital, Yokohama, Japan.
Takayuki OkamuraDepartment of Medicine and Clinical Science, Yamaguchi University Graduate School of Medicine, Ube, Japan.
Ryoji NagoshiDepartment of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Yusuke WatanabeDepartment of Medicine, Division of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.
Nobuaki SuzukiDivision of Cardiology, Teikyo University Mizonokuchi Hospital, Kawasaki, Japan.
Takahiro MoriDepartment of Cardiology & Clinical Research Centre, National Hospital Organization, Kyusyu Medical Centre, Fukuoka, Japan.
Toshiro ShinkeDepartment of Medicine, Division of Cardiology, Showa University School of Medicine, Tokyo, Japan.
Junya ShiteDepartment of Cardiology, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan.
Ken KozumaDepartment of Medicine, Division of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Intracoronary imaging improves clinical outcomes after stenting of complex coronary bifurcation lesions (CBLs), but the impact of Medina classification-based CBL distribution on outcomes of imaging-guided bifurcation stenting is unclear. Methods: In this integrated analysis of four previous studies, in which all CBLs were treated with drug-eluting stents under intravascular ultrasound or optical coherence tomography guidance, the distribution of 763 CBLs was assessed using angiographic Medina classification. Major adverse cardiac events (MACE), including target lesion revascularization (TLR), myocardial infarction, stent thrombosis, and cardiac death, were investigated at 1-year follow-up. Results: The most and least prevalent Medina subtypes were 0-1-0 (27.9 %) and 0-0-1 lesions (2.8 %). The most and least frequent MACE/TLR rates were 18.2 %/18.2 % for 0-0-1 lesions and 4.1 %/2.8 % for 0-1-0 lesions. Risks were higher for 0-0-1 lesions than for 0-1-0 lesions for both MACE (hazard ratio [HR]: 4.04, 95 % confidence interval [CI]: 1.21-13.45, p = 0.02) and TLR (HR: 6.19, 95 % CI: 1.69-22.74, p = 0.006). MACE rates were similar for true and non-true CBLs excluding 0-0-1 lesions (8.2 % and 5.9 %, HR 1.54, 95 % CI: 0.86-2.77, p = 0.15), while MACE (HR: 3.25, 95 % CI: 1.10-9.63, p = 0.03) and TLR (HR: 4.24, 95 % CI: 1.38-12.96, p = 0.01) risks were higher for 0-0-1 lesions. Conclusions: This integrated analysis of imaging-guided bifurcation stenting demonstrated similar clinical outcomes in true and non-true CBLs, except for 0-0-1 lesions, which had a significantly higher risk of MACE/TLR.

Indexed as

Coronary bifurcationDrug-eluting stentIntracoronary imagingMedina classification

Identifiers

PMID38076349
PMCPMC10700802

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.