Document Detail

Usefulness of Intravascular Ultrasound Guidance in Percutaneous Coronary Intervention With Second-Generation Drug-Eluting Stents for Chronic Total Occlusions (from the Multicenter Korean-Chronic Total Occlusion Registry).
MedLine Citation:
PMID:  25001153     Owner:  NLM     Status:  Publisher    
Despite the usefulness of intravascular ultrasound (IVUS) in percutaneous coronary intervention (PCI), the impact of IVUS guidance on clinical outcomes, particularly for chronic total occlusion (CTO) intervention, has rarely been studied. We sought to investigate the clinical usefulness of IVUS-guided CTO intervention with second-generation drug-eluting stent implantation. From 2007 to 2009, a total of 2,568 patients were enrolled in the Korean-CTO registry and 534 patients with successful implantation of second-generation drug-eluting stents were analyzed. IVUS-guided PCI was performed on 206 patients (39%). Clinical outcomes at 2 years were compared between the IVUS-guidance group and the angiography-guidance group in 201 propensity score-matched pairs. The primary end point was the occurrence of definite or probable stent thrombosis. Clinical characteristics were similar between both groups after matching. At 2 years, the IVUS-guidance group showed significantly less stent thrombosis than the angiography-guidance group (0% vs 3.0%, p = 0.014) and a lesser trend toward myocardial infarction (1.0% vs 4.0%, p = 0.058). Target lesion revascularization (TLR) and major adverse cardiovascular event rates were similar. However, a significant interaction was observed between the use of IVUS and lesion length for predicting the TLR (p = 0.037), suggesting usefulness of IVUS in long-lesion (≥3 cm) relative to short-lesion CTO. In conclusion, although IVUS-guided CTO PCI was not associated with a reduction in overall major adverse cardiovascular events, IVUS guidance appears to be associated with a reduction of stent thrombosis and myocardial infarction compared with angiography-guided CTO PCI. Additionally, TLR occurred less frequently in the IVUS-guidance group, especially for long lesions.
Sung-Jin Hong; Byeong-Keuk Kim; Dong-Ho Shin; Jung-Sun Kim; Myeong-Ki Hong; Hyeon-Cheol Gwon; Hyo-Soo Kim; Cheol Woong Yu; Hun Sik Park; In-Ho Chae; Seung-Woon Rha; Seung-Hwan Lee; Moo-Hyun Kim; Seung-Ho Hur; Yangsoo Jang;
Related Documents :
15710753 - T-vector direction differentiates postpacing from ischemic t-wave inversion in precordi...
22622703 - Emerging beneficial roles of sirtuins in heart failure.
25359403 - Varying definitions for periprocedural myocardial infarction alter event rates and prog...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-6-6
Journal Detail:
Title:  The American journal of cardiology     Volume:  -     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2014 Jun 
Date Detail:
Created Date:  2014-7-8     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2014 Elsevier Inc. All rights reserved.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

Previous Document:  Meta-Analysis of the Influence of Chronic Kidney Disease on the Risk of Thromboembolism Among Patien...
Next Document:  Meta-Analysis of Randomized Controlled Trials of Preprocedural Statin Administration for Reducing Co...