Outcomes of predefined optimisation criteria for intravascular ultrasound guidance of left main stenting
| Autor: | Fernando Alfonso, Sofia Gonzalez Lizarbe, Lola Gutierrez Alonso, Javier Zueco, Felipe Hernández, Tamara Garcia Camarero, Gabriela Veiga Fernandez, Dae-Hyun Lee Hwang, Ángel Sánchez-Recalde, José Antonio Baz Alonso, Íñigo Lozano Martínez-Luengas, Armando Pérez de Prado, Fermin Sainz Laso, José M. de la Torre Hernández, Joan Antoni Gómez-Hospital |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Infarction Coronary Artery Disease 030204 cardiovascular system & hematology Coronary Angiography 03 medical and health sciences 0302 clinical medicine Percutaneous Coronary Intervention Internal medicine Intravascular ultrasound medicine Clinical endpoint Humans cardiovascular diseases 030212 general & internal medicine Prospective Studies Prospective cohort study Ultrasonography Interventional medicine.diagnostic_test business.industry Incidence (epidemiology) Coronary Stenosis Drug-Eluting Stents equipment and supplies medicine.disease surgical procedures operative Treatment Outcome Propensity score matching Angiography Conventional PCI cardiovascular system Cardiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 16(3) |
| ISSN: | 1969-6213 |
| Popis: | Aims This study sought to investigate the prognostic effect of a protocol with optimisation targets for intravascular ultrasound (IVUS)-guided left main (LM) revascularisation. Methods and results A protocol was prospectively applied for IVUS-guided LM revascularisation (IVUS-PRO group) including predefined optimisation targets. Using propensity score matching, we selected as control groups patients with angiography-guided PCI (ANGIO group) and IVUS-guided PCI (IVUS group) from a large multicentre registry. The primary endpoint was a composite of cardiac death, LM-related infarction and LM revascularisation at 12 months. In each group, 124 patients with comparable characteristics were included. The incidence of the primary outcome was significantly higher in the ANGIO group compared to the IVUS-PRO group (12.9% vs 4.8%, HR 0.35, 95% CI: 0.15 to 0.82, p=0.02), but not with respect to the IVUS group (12.9% vs 8%, HR 0.51, 95% CI: 0.20 to 1.22, p=0.1), driven by a lower rate of LM revascularisation (8% in the ANGIO group, 6.4% in the IVUS group and 3.2% in the IVUS-PRO group). IVUS-PRO resulted in being an independent risk predictor (HR 0.45, 95% CI: 0.15 to 0.98; p=0.041). Conclusions IVUS guidance of LM stenting provides prognostic benefit with respect to the use of angiography alone, particularly when following a protocol with these predefined optimisation criteria. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|