Author + information
- Yida Tang1,
- Jian Tian2,
- Changdong Guan3,
- Wenyao Wang4,
- Kuo Zhang5,
- Jue Chen6,
- Yongjian Wu7,
- Hongbing Yan8,
- Yanyan Zhao9,
- Shubin Qiao10,
- Yuejin Yang11,
- Gary Mintz12 and
- Bo Xu13
- 1Fuwai Hospital, Beijing, Beijing, China
- 2Stanford, Beijing, Beijing, China
- 3Fu Wai Hospital, National Center for Cardiovascular Diseases, Beijing, Beijing, China
- 4National Center for Cardiovascular Diseases, Fuwai Hospital, CAMS & PUMC, Beijing, Beijing, China
- 5Fuwai Hospital, Beijing, China
- 6Fuwai Hospital, Beijing, Beijing, China
- 7Fu Wai Hospital, Beijing, Beijing, China
- 8The 15th Division, FuWai Hospital, Beijing, Beijing, China
- 9Fuwai Hospital, Beijing, China
- 10Beijing Fuwai Hospital, Beijing, Beijing, China
- 11Cardiovascular Institute and Fu Wai Hospital, Beijing, Beijing, China
- 12Cardiovascular Research Foundation, Washington, District of Columbia, United States
- 13Fu Wai Hospital, Beijing, Beijing, China
Although intravascular ultrasound (IVUS) guidance has been reported to be useful in stenting unprotected left main coronary artery (LMCA) stenosis patients, its impact on long-term prognosis is still unclear. This study sought to compare the safety and efficacy outcomes in patients with unprotected LMCA disease who underwent elective stenting under the guidance of IVUS or conventional angiography at a large single center.
The primary safety outcome was the composite of all-cause death and myocardial infarction (MI), and the primary efficacy outcome was target vessel revascularization (TVR), both at 3 years.
Between January 2004 and December 2011, a total of 1,899 patients underwent IVUS-guided (n=713, 37.5%) or conventional angiography-guided (n=1186, 62.5%) stenting were included in this analysis. At 3 years, the unadjusted primary safety outcome trended lower in the IVUS-guided group versus the angiography-guided (6.9% vs. 8.4%, p = 0.22) although the TVR was similar between two groups (6.0%, vs. 6.0%, p = 0.97). However, after adjustment for differences in baseline risk factors, IVUS-guidance was associated with significantly lower incidence of the composite of all-cause death and MI (hazard ratio [HR]: 0.65; 95% confidence interval [CI]: 0.50 to 0.84; p = 0.001), although there was still no significant difference in TVR between the two groups (HR: 1.09; 95% CI: 0.84 to 1.42; p = 0.53).
IVUS guidance has benefits in improving the long-term prognosis for unprotected LMCA PCI.
CORONARY: PCI Outcomes