Intravascular ultrasound-guided primary percutaneous coronary intervention with drug-eluting stent implantation in patients with ST-segment elevation myocardial infarction

Young Jin Youn, Junghan Yoon, Jun Won Lee, Sung Gyun Ahn, Min Soo Ahn, Jang Young Kim, Byung Soo Yoo, Seung Hwan Lee, Kyung Hoon Choe

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Abstract

Background: Studies investigating the clinical outcome of intravascular ultrasound (IVUS)-guided primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) show conflicting results. The aim of our study was to evaluate whether IVUS-guidedPPCI with drug-eluting stents (DESs) in STEMI patients improves clinical outcome. Hypothesis: IVUS-guided PPCI is superior to angio-guided PPCI. Methods: Three hundred forty-one patients who underwent PPCI for STEMI and survived the hospitalization were enrolled in this study. Two hundred sixteen (63.3%) patients were treated with angio-guided PPCI and 125 (36.7%) patients were treated with IVUS-guided PPCI. The primary endpoint was defined as the composite of death, myocardial infarction, target vessel revascularization, and target lesion revascularization at the 3-year follow-up visit. Results: Male gender, dyslipidemia, and smoking were frequent in the IVUS-guided PPCI group. These patients had a higher rate of radial approach, adjunctive ballooning, thrombectomy, and the use of a glycoprotein IIb/IIIa inhibitor. The number and length of implanted stents were higher in the IVUS-guided PPCI group. The primary end point (18.1% vs 12.8%, P = 0.22) and stent thrombosis (2.8% vs 2.4%, P = 1.00) was not different between the groups. Conclusions: In our observational study, IVUS-guided PPCI with DESs in patients with STEMI did not improve clinical outcome or stent thrombosis.

Original languageEnglish
Pages (from-to)706-713
Number of pages8
JournalClinical Cardiology
Volume34
Issue number11
DOIs
Publication statusPublished - 2011 Nov 1

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All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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