Three-year major clinical outcomes of angiography-guided single stenting technique in non-complex left main coronary artery diseases

Yong Hoon Kim, Ae Young Her, Seung-Woon Rha, Byoung Geol Choi, Minsuk Shim, Seyeon Choi, Jae Kyeong Byun, Hu Li, Woohyeun Kim, Jun Hyuk Kang, Jah Yeon Choi, Eun Jin Park, Sung Hun Park, Sunki Lee, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog SeoDong Joo Oh

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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 IVUSguided 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.

Original languageEnglish
Pages (from-to)704-713
Number of pages10
JournalInternational Heart Journal
Volume58
Issue number5
DOIs
Publication statusPublished - 2017

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Keywords

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

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Kim, Y. H., Her, A. Y., Rha, S-W., Choi, B. G., Shim, M., Choi, S., Byun, J. K., Li, H., Kim, W., Kang, J. H., Choi, J. Y., Park, E. J., Park, S. H., Lee, S., Na, J. O., Choi, C. U., Lim, H. E., Kim, E. J., Park, C. G., ... Oh, D. J. (2017). Three-year major clinical outcomes of angiography-guided single stenting technique in non-complex left main coronary artery diseases. International Heart Journal, 58(5), 704-713. https://doi.org/10.1536/ihj.17-115