Intravascular ultrasound-guided percutaneous coronary intervention improves the clinical outcome in patients undergoing multiple overlapping drug-eluting stents implantation

Sung Gyun Ahn, Junghan Yoon, Joong Kyung Sung, Ji Hyun Lee, Junwon Lee, G. Jin Youn, Minsoo Ahn, Jang Young Kim, Byungsu Yoo, Seunghwan Lee, Kyung Hoon Choe

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Abstract

Background and Objectives: Stented segment length is a predictive factor for restenosis and stent thrombosis still in the drug-eluting stent (DES) era, and the benefit of routine intravascular ultrasound (IVUS) is still unclear. The aim of the present study was to investigate whether IVUS-guided percutaneous coronary intervention (PCI) improved the vascular outcomes as compared with conventional PCI in the treatment of diffuse coronary artery disease. Subjects and Methods: From our registry database from January 2006 to May 2009, we identified 85 consecutive patients with de novo coronary lesions treated with at least 64 mm of multiple, overlapping DES. The 2-year rate of major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, non-fatal myocardial infarction, target lesion revascularization (TLR), or stent thrombosis, was compared according to the use of IVUS. Results: The 2-year MACE rate was lower in the IVUS-guided group than that of the angiography-guided group (8% vs. 33.3%, p=0.005). The incidence of TLR was lower in patients with IVUS use than in those without IVUS use (0% vs. 27.8%, p<0.001). On Cox proportional hazard analysis, no IVUS use {hazard ratio (HR) 5.917, 95% confidence interval (CI) 1.037-33.770, p=0.045} and age (HR 1.097, 95% CI 1.006-1.138, p=0.032) were unfavorable predictors for the 2-year MACE. Conclusion: The use of IVUS may improve the effectiveness and safety of multiple overlapping drug-eluting stenting for long, diffuse coronary lesions.

Original languageEnglish
Pages (from-to)231-238
Number of pages8
JournalKorean Circulation Journal
Volume43
Issue number4
DOIs
Publication statusPublished - 2013 Apr 1

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Drug-Eluting Stents
Percutaneous Coronary Intervention
Stents
Thrombosis
Confidence Intervals
Blood Vessels
Registries
Coronary Artery Disease
Angiography
Myocardial Infarction
Databases
Safety
Incidence
Pharmaceutical Preparations
Therapeutics

All Science Journal Classification (ASJC) codes

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Intravascular ultrasound-guided percutaneous coronary intervention improves the clinical outcome in patients undergoing multiple overlapping drug-eluting stents implantation",
abstract = "Background and Objectives: Stented segment length is a predictive factor for restenosis and stent thrombosis still in the drug-eluting stent (DES) era, and the benefit of routine intravascular ultrasound (IVUS) is still unclear. The aim of the present study was to investigate whether IVUS-guided percutaneous coronary intervention (PCI) improved the vascular outcomes as compared with conventional PCI in the treatment of diffuse coronary artery disease. Subjects and Methods: From our registry database from January 2006 to May 2009, we identified 85 consecutive patients with de novo coronary lesions treated with at least 64 mm of multiple, overlapping DES. The 2-year rate of major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, non-fatal myocardial infarction, target lesion revascularization (TLR), or stent thrombosis, was compared according to the use of IVUS. Results: The 2-year MACE rate was lower in the IVUS-guided group than that of the angiography-guided group (8{\%} vs. 33.3{\%}, p=0.005). The incidence of TLR was lower in patients with IVUS use than in those without IVUS use (0{\%} vs. 27.8{\%}, p<0.001). On Cox proportional hazard analysis, no IVUS use {hazard ratio (HR) 5.917, 95{\%} confidence interval (CI) 1.037-33.770, p=0.045} and age (HR 1.097, 95{\%} CI 1.006-1.138, p=0.032) were unfavorable predictors for the 2-year MACE. Conclusion: The use of IVUS may improve the effectiveness and safety of multiple overlapping drug-eluting stenting for long, diffuse coronary lesions.",
author = "Ahn, {Sung Gyun} and Junghan Yoon and Sung, {Joong Kyung} and Lee, {Ji Hyun} and Junwon Lee and Youn, {G. Jin} and Minsoo Ahn and Kim, {Jang Young} and Byungsu Yoo and Seunghwan Lee and Choe, {Kyung Hoon}",
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Intravascular ultrasound-guided percutaneous coronary intervention improves the clinical outcome in patients undergoing multiple overlapping drug-eluting stents implantation. / Ahn, Sung Gyun; Yoon, Junghan; Sung, Joong Kyung; Lee, Ji Hyun; Lee, Junwon; Youn, G. Jin; Ahn, Minsoo; Kim, Jang Young; Yoo, Byungsu; Lee, Seunghwan; Choe, Kyung Hoon.

In: Korean Circulation Journal, Vol. 43, No. 4, 01.04.2013, p. 231-238.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Intravascular ultrasound-guided percutaneous coronary intervention improves the clinical outcome in patients undergoing multiple overlapping drug-eluting stents implantation

AU - Ahn, Sung Gyun

AU - Yoon, Junghan

AU - Sung, Joong Kyung

AU - Lee, Ji Hyun

AU - Lee, Junwon

AU - Youn, G. Jin

AU - Ahn, Minsoo

AU - Kim, Jang Young

AU - Yoo, Byungsu

AU - Lee, Seunghwan

AU - Choe, Kyung Hoon

PY - 2013/4/1

Y1 - 2013/4/1

N2 - Background and Objectives: Stented segment length is a predictive factor for restenosis and stent thrombosis still in the drug-eluting stent (DES) era, and the benefit of routine intravascular ultrasound (IVUS) is still unclear. The aim of the present study was to investigate whether IVUS-guided percutaneous coronary intervention (PCI) improved the vascular outcomes as compared with conventional PCI in the treatment of diffuse coronary artery disease. Subjects and Methods: From our registry database from January 2006 to May 2009, we identified 85 consecutive patients with de novo coronary lesions treated with at least 64 mm of multiple, overlapping DES. The 2-year rate of major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, non-fatal myocardial infarction, target lesion revascularization (TLR), or stent thrombosis, was compared according to the use of IVUS. Results: The 2-year MACE rate was lower in the IVUS-guided group than that of the angiography-guided group (8% vs. 33.3%, p=0.005). The incidence of TLR was lower in patients with IVUS use than in those without IVUS use (0% vs. 27.8%, p<0.001). On Cox proportional hazard analysis, no IVUS use {hazard ratio (HR) 5.917, 95% confidence interval (CI) 1.037-33.770, p=0.045} and age (HR 1.097, 95% CI 1.006-1.138, p=0.032) were unfavorable predictors for the 2-year MACE. Conclusion: The use of IVUS may improve the effectiveness and safety of multiple overlapping drug-eluting stenting for long, diffuse coronary lesions.

AB - Background and Objectives: Stented segment length is a predictive factor for restenosis and stent thrombosis still in the drug-eluting stent (DES) era, and the benefit of routine intravascular ultrasound (IVUS) is still unclear. The aim of the present study was to investigate whether IVUS-guided percutaneous coronary intervention (PCI) improved the vascular outcomes as compared with conventional PCI in the treatment of diffuse coronary artery disease. Subjects and Methods: From our registry database from January 2006 to May 2009, we identified 85 consecutive patients with de novo coronary lesions treated with at least 64 mm of multiple, overlapping DES. The 2-year rate of major adverse cardiovascular events (MACE), defined as the composite of cardiovascular death, non-fatal myocardial infarction, target lesion revascularization (TLR), or stent thrombosis, was compared according to the use of IVUS. Results: The 2-year MACE rate was lower in the IVUS-guided group than that of the angiography-guided group (8% vs. 33.3%, p=0.005). The incidence of TLR was lower in patients with IVUS use than in those without IVUS use (0% vs. 27.8%, p<0.001). On Cox proportional hazard analysis, no IVUS use {hazard ratio (HR) 5.917, 95% confidence interval (CI) 1.037-33.770, p=0.045} and age (HR 1.097, 95% CI 1.006-1.138, p=0.032) were unfavorable predictors for the 2-year MACE. Conclusion: The use of IVUS may improve the effectiveness and safety of multiple overlapping drug-eluting stenting for long, diffuse coronary lesions.

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