Clinical impact of intravascular ultrasound-guided chronic total occlusion intervention with zotarolimus-eluting versus biolimus-eluting stent implantation randomized study

Byeong Keuk Kim, Dong Ho Shin, Myeong Ki Hong, Hun Sik Park, Seung-Woon Rha, Gary S. Mintz, Jung Sun Kim, Je Sang Kim, Seung Jin Lee, Hee Yeol Kim, Bum Kee Hong, Woong Chol Kang, Jin Ho Choi, Yangsoo Jang

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Background-There have been no randomized studies comparing intravascular ultrasound (IVUS)-guided versus conventional angiography-guided chronic total occlusion (CTO) intervention using new-generation drug-eluting stent Therefore, we conducted a prospective, randomized, multicenter trial designed to test the hypothesis that IVUS-guided CTO intervention is superior to angiography-guided intervention. Methods and Results-After successful guidewire crossing, 402 patients with CTOs were randomized to the IVUS-guided group (n=201) or the angiography-guided group (n=201) and secondarily randomized to Resolute zotarolimus-eluting stents or Nobori biolimus-eluting stents. The primary and secondary end points were cardiac death and a major adverse cardiac event defined as the composite of cardiac death, myocardial infarction, or target-vessel revascularization, respectively. After 12-month follow-up, the rate of cardiac death was not significantly different between the IVUSguided group (0%) and the angiography-guided group (1.0%; P by log-rank test=0.16). However, major adverse cardiac event rates were significantly lower in the IVUS-guided group than that in the angiography-guided group (2.6% versus 7.1%; P=0.035; hazard ratio, 0.35; 95% confidence interval, 0.13-0.97). Occurrence of the composite of cardiac death or myocardial infarction was significantly lower in the IVUS-guided group (0%) than in the angiography-guided group (2.0%; P=0.045). The rates of target-vessel revascularization were not significantly different between the 2 groups. In the comparison between Resolute zotarolimus-eluting stent and Nobori biolimus-eluting stent, major adverse cardiac event rates were not significantly different (4.0% versus 5.7%; P=0.45). Conclusions-Although IVUS-guided CTO intervention did not significantly reduce cardiac mortality, this randomized study demonstrated that IVUS-guided CTO intervention might improve 12-month major adverse cardiac event rate after new-generation drug-eluting stent implantation when compared with conventional angiography-guided CTO intervention.

Original languageEnglish
Article numbere002592
JournalCirculation: Cardiovascular Interventions
Volume8
Issue number7
DOIs
Publication statusPublished - 2015 May 1
Externally publishedYes

    Fingerprint

Keywords

  • Coronary Occlusion
  • Drug-Eluting Stents
  • Ultrasonography, Interventional

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, B. K., Shin, D. H., Hong, M. K., Park, H. S., Rha, S-W., Mintz, G. S., Kim, J. S., Kim, J. S., Lee, S. J., Kim, H. Y., Hong, B. K., Kang, W. C., Choi, J. H., & Jang, Y. (2015). Clinical impact of intravascular ultrasound-guided chronic total occlusion intervention with zotarolimus-eluting versus biolimus-eluting stent implantation randomized study. Circulation: Cardiovascular Interventions, 8(7), [e002592]. https://doi.org/10.1161/CIRCINTERVENTIONS.115.002592