Usefulness of Minimum Stent Cross Sectional Area as a Predictor of Angiographic Restenosis After Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction (from the HORIZONS-AMI Trial IVUS Substudy)
| Autor: | Roxana Mehran, Ecaterina Cristea, Alexandra J. Lansky, Helen Parise, Gregg W. Stone, Giulio Guagliumi, Mirle A. Kellett, Bruce R. Brodie, Bernhard Witzenbichler, Gary S. Mintz, Ovidiu Dressler, So-Yeon Choi, Akiko Maehara |
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| Rok vydání: | 2012 |
| Předmět: |
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medicine.medical_specialty medicine.medical_treatment Myocardial Infarction Coronary Angiography Prosthesis Design law.invention Coronary Restenosis Randomized controlled trial law Internal medicine Angioplasty Antithrombotic Intravascular ultrasound Diabetes Mellitus medicine Humans Prospective Studies Myocardial infarction Angioplasty Balloon Coronary Prospective cohort study Ultrasonography Interventional medicine.diagnostic_test business.industry Percutaneous coronary intervention Stent Middle Aged medicine.disease Coronary Vessels Multivariate Analysis Cardiology Female Stents Radiology Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 109:455-460 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2011.10.005 |
| Popis: | HORIZONS-AMI was a prospective dual-arm randomized trial of different antithrombotic regimens and stent types in patients with ST-segment elevation myocardial infarction. A formal intravascular ultrasound (IVUS) substudy enrolled 464 patients with baseline and 13-month follow-up at 36 centers. Of them, 318 patients with 355 lesions were evaluated for this study. Angiographic restenosis occurred in 45 of 355 lesions (12.7%). Bare-metal stent use (45.5% vs 21.2%, p0.001) and diabetes mellitus (29.5% vs 10.9%, p0.001) were more prevalent in patients with versus without restenosis. Postprocedure IVUS minimum lumen area (5.6 mm(2), 5.0 to 6.1, vs 6.7 mm(2), 6.5 to 6.9, p0.001), minimum stent area (5.7 mm(2), 5.1 to 6.3, vs 6.9 mm(2), 6.6 to 7.1, p0.001), and reference average lumen area (7.7 mm(2), 6.8 to 8.6, vs 9.7 mm(2), 9.3 to 10.1, p0.001) were smaller in restenotic versus nonrestenotic lesions. By multivariable analysis, minimum stent area was an independent predictor of angiographic restenosis (odds ratio 0.75, 95% confidence interval 0.61 to 0.93, p = 0.009) in addition to diabetes, bare-metal stent use, and longer stent length. Attenuated plaque behind the stent struts had a trend to predict less binary restenosis (p = 0.07). In conclusion, a smaller IVUS minimum stent area was an independent predictor of angiographic restenosis after primary percutaneous intervention in patients with ST-segment elevation myocardial infarction, similar to patients with stable coronary artery disease. |
| Databáze: | OpenAIRE |
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