Ik Jun Choi1, Sungmin Lim2, Eun Ho Choo3, Byung-Hee Hwang3, Chan Joon Kim4, Mahn-Won Park5, Jong-Min Lee4, Chul Soo Park6, Hee Yeol Kim7, Ki-Dong Yoo8, Doo Soo Jeon9, Ho Joong Youn3, Wook-Sung Chung3, Min Chul Kim10, Myung Ho Jeong10, Youngkeun Ahn10, Kiyuk Chang11. 1. Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea; Catholic Research Institute for Intractable Cardiovascular Disease (CRID), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 2. Catholic Research Institute for Intractable Cardiovascular Disease (CRID), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 3. Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 4. Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 5. Division of Cardiology, Department of Internal Medicine, Daejeon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 6. Division of Cardiology, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 7. Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 8. Division of Cardiology, Department of Internal Medicine, St. Vincent's hospital, The Catholic University of Korea, Seoul, Korea. 9. Division of Cardiology, Department of Internal Medicine, Incheon St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. 10. Cardiovascular Center, Chonnam National University Hospital, Chonnam National University, Gwangju, Korea. 11. Catholic Research Institute for Intractable Cardiovascular Disease (CRID), College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea. Electronic address: kiyuk@catholic.ac.kr.
Abstract
OBJECTIVES: The aim of this study was to examine the impact of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) on long-term clinical outcomes in patients with acute myocardial infarction (AMI). BACKGROUND: IVUS-guided PCI has been associated with improved cardiovascular outcomes. However, the beneficial effect of IVUS-guided PCI in patients with AMI in the drug-eluting stent era remains unclear. METHODS: Patients who underwent PCI with drug-eluting stents were selected from 10,719 patients enrolled in a multicenter AMI registry. The included patients were classified into 2 groups according to the use or nonuse of IVUS. The primary outcome was a composite of major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, and target lesion revascularization, during long-term follow-up. RESULTS: A total of 9,846 patients were treated with IVUS-guided PCI (n = 2,032) or angiography-guided PCI (n = 7,814). IVUS-guided PCI was associated with reduced MACE (HR: 0.779; 95% CI: 0.689-0.880; P < 0.001). The results were consistent after multivariable regression and propensity score matching. One-year landmark analysis showed a lower risk for MACE within 1 year (HR: 0.766; 95% CI: 0650-0.903; P = 0.002) and beyond 1 year (HR: 0.796; 95% CI: 0663-0.956; P = 0.014) after index PCI. CONCLUSIONS: The use of IVUS was associated with better long-term cardiovascular outcomes. The clinical benefit of IVUS was maintained both within and beyond 1 year after index PCI. The use of IVUS in PCI should be considered for patients with AMI.
OBJECTIVES: The aim of this study was to examine the impact of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) on long-term clinical outcomes in patients with acute myocardial infarction (AMI). BACKGROUND: IVUS-guided PCI has been associated with improved cardiovascular outcomes. However, the beneficial effect of IVUS-guided PCI in patients with AMI in the drug-eluting stent era remains unclear. METHODS: Patients who underwent PCI with drug-eluting stents were selected from 10,719 patients enrolled in a multicenter AMI registry. The included patients were classified into 2 groups according to the use or nonuse of IVUS. The primary outcome was a composite of major adverse cardiovascular events (MACE), including cardiovascular death, myocardial infarction, and target lesion revascularization, during long-term follow-up. RESULTS: A total of 9,846 patients were treated with IVUS-guided PCI (n = 2,032) or angiography-guided PCI (n = 7,814). IVUS-guided PCI was associated with reduced MACE (HR: 0.779; 95% CI: 0.689-0.880; P < 0.001). The results were consistent after multivariable regression and propensity score matching. One-year landmark analysis showed a lower risk for MACE within 1 year (HR: 0.766; 95% CI: 0650-0.903; P = 0.002) and beyond 1 year (HR: 0.796; 95% CI: 0663-0.956; P = 0.014) after index PCI. CONCLUSIONS: The use of IVUS was associated with better long-term cardiovascular outcomes. The clinical benefit of IVUS was maintained both within and beyond 1 year after index PCI. The use of IVUS in PCI should be considered for patients with AMI.
Authors: Tobias Wissel; Katharina A Riedl; Klaus Schaefers; Hannes Nickisch; Fabian J Brunner; Nikolas D Schnellbaecher; Stefan Blankenberg; Moritz Seiffert; Michael Grass Journal: J Med Imaging (Bellingham) Date: 2022-03-28
Authors: Frederik T W Groenland; Karim D Mahmoud; Tara Neleman; Annemieke C Ziedses des Plantes; Alessandra Scoccia; Jurgen Ligthart; Karen T Witberg; Rutger-Jan Nuis; Wijnand K den Dekker; Jeroen M Wilschut; Roberto Diletti; Felix Zijlstra; Isabella Kardys; Paul Cummins; Nicolas M Van Mieghem; Joost Daemen Journal: Open Heart Date: 2022-04
Authors: Joana Rigueira; Inês Aguiar-Ricardo; Pedro Carrilho-Ferreira; Miguel Nobre Menezes; Sara Pereira; Pedro S Morais; Pedro Canas da Silva; Fausto J Pinto Journal: Rev Bras Ter Intensiva Date: 2022 Apr-Jun