Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Chronic Kidney Disease

被引：0

作者：

Yamamoto, Ko ^{[1
]}

Shiomi, Hiroki ^{[2
]}

Nishikawa, Ryusuke ^{[2
]}

Morimoto, Takeshi ^{[3
]}

Miyazawa, Akiyoshi ^{[4
]}

Naganuma, Toru ^{[5
]}

Suwa, Satoru ^{[6
]}

Fujita, Takanari ^{[7
]}

Domei, Takenori ^{[1
]}

Tatsushima, Shojiro ^{[7
]}

Hamaguchi, Yukihiro ^{[8
]}

Nishimoto, Yuji ^{[9
]}

Matsuda, Kensho ^{[10
]}

Takayama, Yohei ^{[11
]}

Kuribara, Jun ^{[12
]}

Kirigaya, Hidekuni ^{[13
]}

Yoneda, Kohei ^{[14
]}

Shigetoshi, Masataka ^{[15
]}

Yokomatsu, Takafumi ^{[16
]}

Kadota, Kazushige ^{[17
]}

Ando, Kenji ^{[1
]}

Hibi, Kiyoshi ^{[13
]}

Ono, Koh ^{[2
]}

Kimura, Takeshi ^{[18
]}

机构：

[1] Kokura Mem Hosp, Dept Cardiol, Kitakyushu, Japan

[2] Kyoto Univ, Grad Sch Med, Dept Cardiovasc Med, Kyoto, Japan

[3] Hyogo Coll Med, Dept Clin Epidemiol, Nishinomiya, Japan

[4] Cardiocore Japan, Tokyo, Japan

[5] New Tokyo Hosp, Dept Cardiovasc Med, Matsudo, Japan

[6] Juntendo Univ, Shizuoka Hosp, Dept Cardiol, Izunokuni, Japan

[7] Japanese Red Cross Wakayama Med Ctr, Dept Cardiol, Wakayama, Japan

[8] Shizuoka Prefectural Gen Hosp, Dept Cardiol, Shizuoka, Japan

[9] Hyogo Prefectural Amagasaki Gen Med Ctr, Dept Cardiol, Amagasaki, Japan

[10] Ehime Prefectural Cent Hosp, Dept Cardiol, Matsuyama, Japan

[11] Hamamatsu Med Ctr, Dept Cardiol, Hamamatsu, Japan

[12] Gunma Prefectural Cardiovasc Ctr, Dept Cardiol, Maebashi, Japan

[13] Yokohama City Univ, Med Ctr, Div Cardiol, Yokohama, Japan

[14] Tokushima Red Cross Hosp, Dept Cardiol, Tokushima, Japan

[15] Natl Hosp Org Okayama Med Ctr, Dept Cardiol, Okayama, Japan

[16] Mitsubishi Kyoto Hosp, Dept Cardiol, Kyoto, Japan

[17] Kurashiki Cent Hosp, Dept Cardiol, Kurashiki, Japan

[18] Hirakata Kohsai Hosp, Dept Cardiol, Hirakata, Japan

来源：

AMERICAN JOURNAL OF CARDIOLOGY | 2025年 / 239卷

关键词：

chronic kidney disease; drug-eluting stent; intravascular ultrasound; percutaneous coronary intervention; EVEROLIMUS-ELUTING STENTS; ARTERY-DISEASE; BYPASS-SURGERY; REVASCULARIZATION; TRIALS; RISKS; DEATH;

D O I：

10.1016/j.amjcard.2024.12.020

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

There is a scarcity of data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and chronic kidney disease (CKD). The Optimal Intravascular Ultrasound (OPTIVUS)-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,015 patients who underwent multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared the clinical outcomes between patients with and without CKD. The primary end point was a composite of death, myocardial infarction, stroke, or any coronary revascularization. There were 528 patients (52.0%) without CKD (estimated glomerular filtration rate [eGFR] >= 60 ml/min/1.73 m2), 391 patients (38.5%) with moderate CKD (60 >eGFR >= 30 ml/min/1.73 m2), and 96 patients (9.5%) with severe CKD (eGFR <30 ml/min/1.73 m2 or hemodialysis). The rate of meeting OPTIVUS criteria was not different across the 3 groups. The cumulative 1-year incidence of the primary end point was 9.1%, 9.0%, and 22.1% in patients without CKD, with moderate CKD, and with severe CKD, respectively (log-rank p <0.001). After adjusting confounders, the higher risk of severe CKD relative to no CKD remained significant for the primary end point (hazard ratio 2.42, 95% confidence interval 1.30 to 4.25, p = 0.01), whereas the risk of moderate CKD relative to no CKD was not significant for the primary end point (hazard ratio 0.97, 95% confidence interval 0.61 to 1.53, p = 0.88). In conclusion, in patients who underwent multivessel IVUS-guided PCI, and were managed with contemporary clinical practice, 1-year clinical outcomes were worse in patients with severe CKD, whereas 1-year clinical outcomes were not different between patients without CKD and with moderate CKD. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

引用

页码：20 / 27

页数：8

共 21 条

[1] Comparative efficacy of coronary artery bypass surgery vs. percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease with or without chronic kidney disease [J].