{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T03:21:26Z","timestamp":1780716086068,"version":"3.54.1"},"reference-count":30,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2015,12,9]],"date-time":"2015-12-09T00:00:00Z","timestamp":1449619200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2016,6]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Historically, percutaneous coronary intervention (PCI) of bifurcation lesions was associated with worse procedural and clinical outcomes when compared with PCI of non\u2010bifurcation lesions. Newer generation drug\u2010eluting stents (DES) might improve long\u2010term clinical outcomes after bifurcation PCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results<\/jats:title><jats:p>The LEADERS trial was a 10\u2010center, assessor\u2010blind, non\u2010inferiority, all\u2010comers trial, randomizing 1,707 patients to treatment with a biolimus A9<jats:sup>TM<\/jats:sup>\u2010eluting stent (BES) with an abluminal biodegradable polymer or a sirolimus\u2010eluting stent (SES) with a durable polymer (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link> Identifier: NCT00389220). Five\u2010year clinical outcomes were compared between patients with and without bifurcation lesions and between BES and SES in the bifurcation lesion subgroup.<\/jats:p><jats:p>There were 497 (29%) patients with at least 1 bifurcation lesion (BES\u2009=\u2009258; SES\u2009=\u2009239). At 5\u2010year follow\u2010up, the composite endpoint of cardiac death, myocardial infarction (MI) and clinically\u2010indicated (CI) target vessel revascularization (TVR) was observed more frequently in the bifurcation group (26.6% vs. 22.4%, <jats:italic>P<\/jats:italic>\u2009=\u20090.049). Within the bifurcation lesion subgroup, no differences were observed in (cardiac) death or MI rates between BES and SES. However, CI target lesion revascularization (TLR) (10.1% vs. 15.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.0495), and CI TVR (12.0% vs. 19.2%, <jats:italic>P<\/jats:italic>\u2009=\u20090.023) rates were significantly lower in the BES group. Definite\/probable stent thrombosis (ST) rate was numerically lower in the BES group (3.1% vs. 5.9%, <jats:italic>P<\/jats:italic>\u2009=\u20090.15). Very late (&gt;1 year) definite\/probable ST rates trended to be lower with BES (0.4% vs. 3.1%, <jats:italic>P<\/jats:italic>\u2009=\u20090.057).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In the treatment of bifurcation lesions, use of BES led to superior long\u2010term efficacy compared with SES. Safety outcomes were comparable between BES and SES, with an observed trend toward a lower rate of very late definite\/probable ST between 1 and 5 years with the BES. \u00a9 2015 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.26344","type":"journal-article","created":{"date-parts":[[2015,12,11]],"date-time":"2015-12-11T05:19:45Z","timestamp":1449811185000},"source":"Crossref","is-referenced-by-count":41,"title":["First generation versus second generation drug\u2010eluting stents for the treatment of bifurcations: 5\u2010year follow\u2010up of the <scp>LEADERS<\/scp> all\u2010comers randomized trial"],"prefix":"10.1002","volume":"87","author":[{"given":"Maik J.","family":"Grundeken","sequence":"first","affiliation":[{"name":"Heartcenter Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna J.","family":"Wykrzykowska","sequence":"additional","affiliation":[{"name":"Heartcenter Academic Medical Center 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Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Onuma","sequence":"additional","affiliation":[{"name":"Thoraxcenter Erasmus Medical Center Rotterdam The Netherlands"},{"name":"Cardialysis BV Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robbert J.","family":"de Winter","sequence":"additional","affiliation":[{"name":"Heartcenter Academic Medical Center Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pawel","family":"Buszman","sequence":"additional","affiliation":[{"name":"American Heart of Poland Ustro\u0144 Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Axel","family":"Linke","sequence":"additional","affiliation":[{"name":"Herzzentrum Leipzig Leipzig Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas","family":"Ischinger","sequence":"additional","affiliation":[{"name":"Kardiologie Im Zentrum Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Klauss","sequence":"additional","affiliation":[{"name":"Kardiologie Innenstadt Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franz","family":"Eberli","sequence":"additional","affiliation":[{"name":"Department of Cardiology Triemli Spital, Zurich  Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Corti","sequence":"additional","affiliation":[{"name":"University Hospital Zurich Zurich Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Wijns","sequence":"additional","affiliation":[{"name":"Department of Cardiology Onze Lieve Vrouw Ziekenhuis Aalst Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Claude","family":"Morice","sequence":"additional","affiliation":[{"name":"Institut Hospitalier Jacques\u2010Cartier Institut Cardiovasculaire 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