Clinical Benefit of Intravascular Imaging Compared With Conventional Angiography in Left Main Coronary Artery Intervention

被引：6

作者：

Kwon, Woochan ^{[3
]}

Lee, Joo Myung ^{[3
]}

Yun, Kyeong Ho ^{[1
,6
]}

Choi, Ki Hong ^{[3
]}

Lee, Seung-Jae ^{[4
]}

Lee, Jong-Young ^{[4
]}

Lee, Sang Yeub ^{[7
,8
]}

Kim, Sang Min ^{[7
]}

Cho, Jae Young ^{[6
]}

Kim, Chan Joon ^{[9
]}

Ahn, Hyo-Suk ^{[9
]}

Nam, Chang-Wook ^{[10
]}

Yoon, Hyuck-Jun ^{[10
]}

Park, Yong Hwan ^{[5
]}

Lee, Wang Soo ^{[11
]}

Jeong, Jin-Ok ^{[12
]}

Song, Pil Sang ^{[12
]}

Doh, Joon-Hyung ^{[13
]}

Jo, Sang-Ho ^{[14
]}

Yoon, Chang-Hwan ^{[15
]}

Kang, Min Gyu ^{[16
]}

Koh, Jin-Sin ^{[16
]}

Lee, Kwan Yong ^{[17
]}

Lim, Young-Hyo ^{[18
]}

Cho, Yun-Hyeong ^{[19
]}

Cho, Jin-Man ^{[20
]}

Jang, Woo Jin ^{[21
]}

Chun, Kook-Jin ^{[22
]}

Hong, David ^{[3
]}

Park, Taek Kyu ^{[3
]}

Yang, Jeong Hoon ^{[3
]}

Choi, Seung-Hyuk ^{[3
]}

Gwon, Hyeon-Cheol ^{[3
]}

Hahn, Joo-Yong ^{[3
]}

Song, Young Bin ^{[2
,3
]}

机构：

[1] Wonkwang Univ Hosp, Dept Cardiovasc Med, 895 Muwang Ro, Iksan 54538, South Korea

[2] Sungkyunkwan Univ, Heart Vasc Stroke Inst, Sch Med, Samsung Med Ctr, 81 Irwon Ro, Seoul 06351, South Korea

[3] Sungkyunkwan Univ, Sch Med, Samsung Med Ctr, Seoul, South Korea

[4] Sungkyunkwan Univ, Kangbuk Samsung Hosp, Sch Med, Seoul, South Korea

[5] Sungkyunkwan Univ, Samsung Changwon Hosp, Sch Med, Seoul, South Korea

[6] Wonkwang Univ Hosp, Iksan, South Korea

[7] Chungbuk Natl Univ, Chungbuk Natl Univ Hosp, Coll Med, Cheongju, South Korea

[8] Chung Ang Univ, Gwangmyeong Hosp, Coll Med, Gwangmyeong, South Korea

[9] Catholic Univ Korea, Uijeongbu St Marys Hosp, Seoul, South Korea

[10] Keimyung Univ, Dongsan Hosp, Daegu, South Korea

[11] Chung Ang Univ, Chung Ang Univ Hosp, Coll Med, Seoul, South Korea

[12] Chungnam Natl Univ, Chungnam Natl Univ Hosp, Coll Med, Daejeon, South Korea

[13] Inje Univ, Ilsan Paik Hosp, Goyang, South Korea

[14] Hallym Univ, Sacred Heart Hosp, Cardiovasc Ctr, Anyang, South Korea

[15] Seoul Natl Univ, Bundang Hosp, Seongnam, South Korea

[16] Gyeongsang Natl Univ, Gyeongsang Natl Univ Hosp, Sch Med, Jinju, South Korea

[17] Catholic Univ Korea, Incheon St Marys Hosp, Seoul, South Korea

[18] Hanyang Univ, Seoul Hosp, Coll Med, Seoul, South Korea

[19] Hanyang Univ, Myongji Hosp, Goyang, South Korea

[20] Kyung Hee Univ Hosp Gangdong, Seoul, South Korea

[21] Ewha Womans Univ, Coll Med, Seoul, South Korea

[22] Pusan Natl Univ, Yangsan Hosp, Yangsan, South Korea

来源：

CIRCULATION-CARDIOVASCULAR INTERVENTIONS | 2023年 / 16卷 / 12期

关键词：

angiography; coronary artery; patients; percutaneous coronary intervention; prognosis; DRUG-ELUTING STENTS; DUAL ANTIPLATELET THERAPY; ULTRASOUND GUIDANCE; MYOCARDIAL-INFARCTION; FOCUSED UPDATE; IMPLANTATION; OUTCOMES; DISEASE; IMPACT; MORTALITY;

D O I：

10.1161/CIRCINTERVENTIONS.123.013359

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND:The RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention) demonstrated that intravascular imaging-guided percutaneous coronary intervention (PCI) improved clinical outcome compared with angiography-guided PCI for patients with complex coronary artery lesions. This study aims to assess whether the prognostic benefit of intravascular imaging-guided procedural optimization persists in patients undergoing PCI for left main coronary artery disease.METHODS:Of 1639 patients enrolled in the RENOVATE-COMPLEX-PCI, 192 patients with left main coronary artery disease were selected for the current prespecified substudy. Selected patients were randomly assigned to either the intravascular imaging-guided PCI group (n=138) or the angiography-guided PCI group (n=54). The primary end point was target vessel failure defined as a composite of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization.RESULTS:At a median follow-up of 2.1 years (interquartile range 1.1 to 3.0 years), intravascular imaging-guided PCI was associated with lower incidence of primary end point compared with angiography-guided PCI (6.8% versus 25.1%; hazard ratio, 0.31 [95% CI, 0.13-0.76]; P=0.010). This significant reduction in primary end point was mainly driven by a lower risk of cardiac death or spontaneous target vessel-related myocardial infarction (1.6% versus 12.7%; hazard ratio, 0.16 [95% CI, 0.03-0.82]; P=0.028). Intravascular imaging-guided PCI was independently associated with a lower risk of primary end point, even after adjusting for various clinical factors (hazard ratio, 0.29 [95% CI, 0.12-0.72]; P=0.007).CONCLUSIONS:Intravascular imaging-guided PCI showed clinical benefit over angiography-guided PCI for left main coronary artery disease in reducing the risk of cardiac death, target vessel-related myocardial infarction, or target vessel revascularization.REGISTRATION:URL: https://www.clinicaltrials.gov; Unique identifier: NCT03381872.

引用

页数：13

共 50 条

[31] Clinical predictors of presence of left main coronary artery disease on angiography in a large cohort
Shah, Svati H.
Nelson, Charlotte
Stafford, Judith A.
Granger, Christopher B.
Kraus, William E.
Hauser, Elizabeth R.
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (09) : 218A - 218A
[32] Left Main Coronary Artery Intervention: Respect the Circumflex
Madan, Mina
CIRCULATION-CARDIOVASCULAR INTERVENTIONS, 2024, 17 (03)
[33] The benefit of complete revascularization in left main percutaneous coronary intervention
Leemasawat, K.
Terashima, M.
Kinoshita, Y.
Suzuki, T.
EUROPEAN HEART JOURNAL, 2017, 38 : 419 - 419
[34] Outcomes of Unprotected Left Main Coronary Artery Percutaneous Intervention as Compared to Multivessel Interventions.
Agarwal, Shikhar
Zaman, Tarique
Tuzcu, E. M.
Shishehbor, Mehdi
Lincoff, A. M.
Whitlow, Patrick
Bajzer, Christopher
Franco, Irving
Nair, Ravi
Raymond, Russell
Ellis, Stephen G.
Kapadia, Samir R.
CIRCULATION, 2010, 122 (21)
[35] Anomalous left main coronary artery detected by CT angiography
Ernesto Forte
Marianna Inglese
Teresa Infante
Concetta Schiano
Claudio Napoli
Andrea Soricelli
Marco Salvatore
Carlo Tedeschi
Surgical and Radiologic Anatomy, 2016, 38 : 987 - 990
[36] Intravascular Ultrasound and Optical Coherence Tomography in the Procedural Planning and Execution of Left Main Coronary Artery Percutaneous Coronary Intervention
David Elison
Antoniette Birs
Jie Zhao
Ravi S. Hira
Current Cardiovascular Imaging Reports, 2019, 12
[37] Intravascular Ultrasound and Optical Coherence Tomography in the Procedural Planning and Execution of Left Main Coronary Artery Percutaneous Coronary Intervention
Elison, David
Birs, Antoniette
Zhao, Jie
Hira, Ravi S.
CURRENT CARDIOVASCULAR IMAGING REPORTS, 2019, 12 (07)
[38] Anomalous left main coronary artery detected by CT angiography
Forte, Ernesto
Inglese, Marianna
Infante, Teresa
Schiano, Concetta
Napoli, Claudio
Soricelli, Andrea
Salvatore, Marco
Tedeschi, Carlo
SURGICAL AND RADIOLOGIC ANATOMY, 2016, 38 (08) : 987 - 990
[39] Comparison of two and three dimensional quantitative coronary angiography to intravascular ultrasound in the assessment of left main coronary artery bifurcation lesions
Kan Jing
Gao Xiaofei
Sandeep, Kumar Gami
Xu Haimei
Zhao Yingying
Chen Shaoliang
Chen Feng
CHINESE MEDICAL JOURNAL, 2014, 127 (06) : 1012 - 1021
[40] Comparison of two and three dimensional quantitative coronary angiography to intravascular ultrasound in the assessment of left main coronary artery bifurcation lesions
Kan Jing
Gao Xiaofei
Kumar Gami Sandeep
Xu Haimei
Zhao Yingying
Chen Shaoliang
Chen Feng
中华医学杂志（英文版）, 2014, 127 (06) : 1012 - 1021

← 1 2 3 4 5 →