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Clin Cardiol. 2011 Nov;34(11):706-13. doi: 10.1002/clc.20966. Epub 2011 Nov 6.

Intravascular ultrasound-guided primary percutaneous coronary intervention with drug-eluting stent implantation in patients with ST-segment elevation myocardial infarction.

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  • 1Division of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, South Korea.

Abstract

BACKGROUND:

Studies investigating the clinical outcome of intravascular ultrasound (IVUS)-guided primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) show conflicting results. The aim of our study was to evaluate whether IVUS-guidedPPCI with drug-eluting stents (DESs) in STEMI patients improves clinical outcome.

HYPOTHESIS:

IVUS-guided PPCI is superior to angio-guided PPCI.

METHODS:

Three hundred forty-one patients who underwent PPCI for STEMI and survived the hospitalization were enrolled in this study. Two hundred sixteen (63.3%) patients were treated with angio-guided PPCI and 125 (36.7%) patients were treated with IVUS-guided PPCI. The primary endpoint was defined as the composite of death, myocardial infarction, target vessel revascularization, and target lesion revascularization at the 3-year follow-up visit.

RESULTS:

Male gender, dyslipidemia, and smoking were frequent in the IVUS-guided PPCI group. These patients had a higher rate of radial approach, adjunctive ballooning, thrombectomy, and the use of a glycoprotein IIb/IIIa inhibitor. The number and length of implanted stents were higher in the IVUS-guided PPCI group. The primary end point (18.1% vs 12.8%, P = 0.22) and stent thrombosis (2.8% vs 2.4%, P = 1.00) was not different between the groups.

CONCLUSIONS:

In our observational study, IVUS-guided PPCI with DESs in patients with STEMI did not improve clinical outcome or stent thrombosis.

© 2011 Wiley Periodicals, Inc.

PMID:
22057856
[PubMed - indexed for MEDLINE]
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