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Int Heart J. 2017 Oct 12;58(5):704-713. doi: 10.1536/ihj.17-115. Epub 2017 Sep 30.

Three-Year Major Clinical Outcomes of Angiography-Guided Single Stenting Technique in Non-Complex Left Main Coronary Artery Diseases.

Kim YH1, Her AY1, Rha SW2,3, Choi BG2, Shim M2, Choi SY2, Byun JK2, Li H2, Kim W2,3, Kang JH2,3, Choi JY2,3, Park EJ2,3, Park SH2,3, Lee S2,3, Na JO2,3, Choi CU2,3, Lim HE2,3, Kim EJ2,3, Park CG2,3, Seo HS2,3, Oh DJ2,3.

Author information

1
Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine.
2
Department of Medicine, Korea University Graduate School.
3
Cardiovascular Center, Korea University Guro Hospital.

Abstract

There is limited long-term comparative clinical outcome data concerning angiography- versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in non-complex left main coronary artery (LMCA) disease treated with the single stenting technique in the drug-eluting stent (DES) era.The aim of this study was to investigate whether angiography-guided stenting is comparable to IVUS-guided stenting during 3-year clinical follow-up periods in patients with non-complex LM disease treated with the single stenting technique.A total of 196 patients treated with either angiography-guided (n = 74) or IVUS-guided (n = 122) PCI were included. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-target vessel revascularization (Non-TVR). To adjust for any potential confounders, propensity score (PS) adjusted analysis was performed.During 3-year follow-up, the PS adjusted Cox-proportional hazard ratio (HR) was not significantly different between the two groups for total death, cardiac death, and MI. Also, TLR and the combined rates of TVR and non-TVR were not significantly different. Finally, MACE was not significantly different between the two groups (HR: 0.63, 95% Confidence interval (CI): 0.33-1.17; P = 0.149).Angiography-guided PCI for non-complex LMCA diseases treated with the single stenting technique showed comparable results compared with IVUS-guided PCI in reducing clinical events during 3-year clinical follow-up in the DES era. Although IVUS guided PCI is the ideal strategy, angiography-guided PCI can be an option for LMCA PCI in some selected cases.

KEYWORDS:

Drug eluting stents; Intravascular ultrasound; Left main coronary artery; Percutaneous coronary intervention

PMID:
28966331
DOI:
10.1536/ihj.17-115
[Indexed for MEDLINE]
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