| Autor: |
Gao XF; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China., Han L; Department of Cardiology, Changshu No. 1 People's Hospital, Changshu 215500, China., Qian XS; Department of Cardiology, The First People's Hospital of Zhangjiagang, Zhangjiagang 215600, China., Ge Z; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China., Kong XQ; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China., Lu S; Department of Cardiology, The First People's Hospital of Taicang, Taicang 215400, China., Kan J; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China., Zuo GF; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China., Zhang JJ; Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, China., Chen SL |
| Abstrakt: |
Objective: To explore the long-term effects of intravascular ultrasound (IVUS) guidance on patients with acute coronary syndrome (ACS) undergoing drug-eluting stents (DES) implantation. Methods: Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. A total of 1 448 all-comer patients were enrolled between 2014 August and 2017 May. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target-vessel-related myocardial infarction, and clinically-driven target vessel revascularization. Results: ACS was present in 1 136 (78.5%) patients, and 3-year clinical follow-up was available in 1 423 patients (98.3%). TVF in the ACS group was 9.6% (109/1 136), which was significantly higher than 4.5% (14/312) in the non-ACS group (log-rank P =0.005). There were 109 TVFs in the ACS patients, with 7.6% (43/569) TVFs in the IVUS group and 11.6% (66/567) TVFs in the angiography group (log-rank P =0.019). Moreover, patients with optimal IVUS guidance were associated with a lower risk of 3-year TVF compared to those with suboptimal IVUS results (5.4% (16/296) vs. 9.9% (27/273),log-rank P =0.041). Conclusions: This ULTIMATE-ACS subgroup analysis showed that ACS patients undergoing DES implantation were associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in patients with ACS, especially in those who had an IVUS-defined optimal procedure. |
