Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the multicenter Korean-chronic total occlusion registry)

Sung Jin Hong, Byeong Keuk Kim, Dong Ho Shin, Jung Sun Kim, Myeong Ki Hong, Hyeon Cheol Gwon, Hyo Soo Kim, Cheol Woong Yu, Hun Sik Park, In Ho Chae, Seung-Woon Rha, Seung Hwan Lee, Moo Hyun Kim, Seung Ho Hur, Yangsoo Jang

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Despite the usefulness of intravascular ultrasound (IVUS) in percutaneous coronary intervention (PCI), the impact of IVUS guidance on clinical outcomes, particularly for chronic total occlusion (CTO) intervention, has rarely been studied. We sought to investigate the clinical usefulness of IVUS-guided CTO intervention with second-generation drug-eluting stent implantation. From 2007 to 2009, a total of 2,568 patients were enrolled in the Korean-CTO registry and 534 patients with successful implantation of second-generation drug-eluting stents were analyzed. IVUS-guided PCI was performed on 206 patients (39%). Clinical outcomes at 2 years were compared between the IVUS-guidance group and the angiography-guidance group in 201 propensity score-matched pairs. The primary end point was the occurrence of definite or probable stent thrombosis. Clinical characteristics were similar between both groups after matching. At 2 years, the IVUS-guidance group showed significantly less stent thrombosis than the angiography-guidance group (0% vs 3.0%, p = 0.014) and a lesser trend toward myocardial infarction (1.0% vs 4.0%, p = 0.058). Target lesion revascularization (TLR) and major adverse cardiovascular event rates were similar. However, a significant interaction was observed between the use of IVUS and lesion length for predicting the TLR (p = 0.037), suggesting usefulness of IVUS in long-lesion (≥3 cm) relative to short-lesion CTO. In conclusion, although IVUS-guided CTO PCI was not associated with a reduction in overall major adverse cardiovascular events, IVUS guidance appears to be associated with a reduction of stent thrombosis and myocardial infarction compared with angiography-guided CTO PCI. Additionally, TLR occurred less frequently in the IVUS-guidance group, especially for long lesions.

Original languageEnglish
Pages (from-to)534-540
Number of pages7
JournalAmerican Journal of Cardiology
Volume114
Issue number4
DOIs
Publication statusPublished - 2014 Aug 15

Fingerprint

Drug-Eluting Stents
Percutaneous Coronary Intervention
Registries
Stents
Angiography
Thrombosis
Myocardial Infarction
Propensity Score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the multicenter Korean-chronic total occlusion registry). / Hong, Sung Jin; Kim, Byeong Keuk; Shin, Dong Ho; Kim, Jung Sun; Hong, Myeong Ki; Gwon, Hyeon Cheol; Kim, Hyo Soo; Yu, Cheol Woong; Park, Hun Sik; Chae, In Ho; Rha, Seung-Woon; Lee, Seung Hwan; Kim, Moo Hyun; Hur, Seung Ho; Jang, Yangsoo.

In: American Journal of Cardiology, Vol. 114, No. 4, 15.08.2014, p. 534-540.

Research output: Contribution to journalArticle

Hong, Sung Jin ; Kim, Byeong Keuk ; Shin, Dong Ho ; Kim, Jung Sun ; Hong, Myeong Ki ; Gwon, Hyeon Cheol ; Kim, Hyo Soo ; Yu, Cheol Woong ; Park, Hun Sik ; Chae, In Ho ; Rha, Seung-Woon ; Lee, Seung Hwan ; Kim, Moo Hyun ; Hur, Seung Ho ; Jang, Yangsoo. / Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the multicenter Korean-chronic total occlusion registry). In: American Journal of Cardiology. 2014 ; Vol. 114, No. 4. pp. 534-540.
@article{3f97726ee2fc4e3989fd17e780be2523,
title = "Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the multicenter Korean-chronic total occlusion registry)",
abstract = "Despite the usefulness of intravascular ultrasound (IVUS) in percutaneous coronary intervention (PCI), the impact of IVUS guidance on clinical outcomes, particularly for chronic total occlusion (CTO) intervention, has rarely been studied. We sought to investigate the clinical usefulness of IVUS-guided CTO intervention with second-generation drug-eluting stent implantation. From 2007 to 2009, a total of 2,568 patients were enrolled in the Korean-CTO registry and 534 patients with successful implantation of second-generation drug-eluting stents were analyzed. IVUS-guided PCI was performed on 206 patients (39{\%}). Clinical outcomes at 2 years were compared between the IVUS-guidance group and the angiography-guidance group in 201 propensity score-matched pairs. The primary end point was the occurrence of definite or probable stent thrombosis. Clinical characteristics were similar between both groups after matching. At 2 years, the IVUS-guidance group showed significantly less stent thrombosis than the angiography-guidance group (0{\%} vs 3.0{\%}, p = 0.014) and a lesser trend toward myocardial infarction (1.0{\%} vs 4.0{\%}, p = 0.058). Target lesion revascularization (TLR) and major adverse cardiovascular event rates were similar. However, a significant interaction was observed between the use of IVUS and lesion length for predicting the TLR (p = 0.037), suggesting usefulness of IVUS in long-lesion (≥3 cm) relative to short-lesion CTO. In conclusion, although IVUS-guided CTO PCI was not associated with a reduction in overall major adverse cardiovascular events, IVUS guidance appears to be associated with a reduction of stent thrombosis and myocardial infarction compared with angiography-guided CTO PCI. Additionally, TLR occurred less frequently in the IVUS-guidance group, especially for long lesions.",
author = "Hong, {Sung Jin} and Kim, {Byeong Keuk} and Shin, {Dong Ho} and Kim, {Jung Sun} and Hong, {Myeong Ki} and Gwon, {Hyeon Cheol} and Kim, {Hyo Soo} and Yu, {Cheol Woong} and Park, {Hun Sik} and Chae, {In Ho} and Seung-Woon Rha and Lee, {Seung Hwan} and Kim, {Moo Hyun} and Hur, {Seung Ho} and Yangsoo Jang",
year = "2014",
month = "8",
day = "15",
doi = "10.1016/j.amjcard.2014.05.027",
language = "English",
volume = "114",
pages = "534--540",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Usefulness of intravascular ultrasound guidance in percutaneous coronary intervention with second-generation drug-eluting stents for chronic total occlusions (from the multicenter Korean-chronic total occlusion registry)

AU - Hong, Sung Jin

AU - Kim, Byeong Keuk

AU - Shin, Dong Ho

AU - Kim, Jung Sun

AU - Hong, Myeong Ki

AU - Gwon, Hyeon Cheol

AU - Kim, Hyo Soo

AU - Yu, Cheol Woong

AU - Park, Hun Sik

AU - Chae, In Ho

AU - Rha, Seung-Woon

AU - Lee, Seung Hwan

AU - Kim, Moo Hyun

AU - Hur, Seung Ho

AU - Jang, Yangsoo

PY - 2014/8/15

Y1 - 2014/8/15

N2 - Despite the usefulness of intravascular ultrasound (IVUS) in percutaneous coronary intervention (PCI), the impact of IVUS guidance on clinical outcomes, particularly for chronic total occlusion (CTO) intervention, has rarely been studied. We sought to investigate the clinical usefulness of IVUS-guided CTO intervention with second-generation drug-eluting stent implantation. From 2007 to 2009, a total of 2,568 patients were enrolled in the Korean-CTO registry and 534 patients with successful implantation of second-generation drug-eluting stents were analyzed. IVUS-guided PCI was performed on 206 patients (39%). Clinical outcomes at 2 years were compared between the IVUS-guidance group and the angiography-guidance group in 201 propensity score-matched pairs. The primary end point was the occurrence of definite or probable stent thrombosis. Clinical characteristics were similar between both groups after matching. At 2 years, the IVUS-guidance group showed significantly less stent thrombosis than the angiography-guidance group (0% vs 3.0%, p = 0.014) and a lesser trend toward myocardial infarction (1.0% vs 4.0%, p = 0.058). Target lesion revascularization (TLR) and major adverse cardiovascular event rates were similar. However, a significant interaction was observed between the use of IVUS and lesion length for predicting the TLR (p = 0.037), suggesting usefulness of IVUS in long-lesion (≥3 cm) relative to short-lesion CTO. In conclusion, although IVUS-guided CTO PCI was not associated with a reduction in overall major adverse cardiovascular events, IVUS guidance appears to be associated with a reduction of stent thrombosis and myocardial infarction compared with angiography-guided CTO PCI. Additionally, TLR occurred less frequently in the IVUS-guidance group, especially for long lesions.

AB - Despite the usefulness of intravascular ultrasound (IVUS) in percutaneous coronary intervention (PCI), the impact of IVUS guidance on clinical outcomes, particularly for chronic total occlusion (CTO) intervention, has rarely been studied. We sought to investigate the clinical usefulness of IVUS-guided CTO intervention with second-generation drug-eluting stent implantation. From 2007 to 2009, a total of 2,568 patients were enrolled in the Korean-CTO registry and 534 patients with successful implantation of second-generation drug-eluting stents were analyzed. IVUS-guided PCI was performed on 206 patients (39%). Clinical outcomes at 2 years were compared between the IVUS-guidance group and the angiography-guidance group in 201 propensity score-matched pairs. The primary end point was the occurrence of definite or probable stent thrombosis. Clinical characteristics were similar between both groups after matching. At 2 years, the IVUS-guidance group showed significantly less stent thrombosis than the angiography-guidance group (0% vs 3.0%, p = 0.014) and a lesser trend toward myocardial infarction (1.0% vs 4.0%, p = 0.058). Target lesion revascularization (TLR) and major adverse cardiovascular event rates were similar. However, a significant interaction was observed between the use of IVUS and lesion length for predicting the TLR (p = 0.037), suggesting usefulness of IVUS in long-lesion (≥3 cm) relative to short-lesion CTO. In conclusion, although IVUS-guided CTO PCI was not associated with a reduction in overall major adverse cardiovascular events, IVUS guidance appears to be associated with a reduction of stent thrombosis and myocardial infarction compared with angiography-guided CTO PCI. Additionally, TLR occurred less frequently in the IVUS-guidance group, especially for long lesions.

UR - http://www.scopus.com/inward/record.url?scp=84906101543&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84906101543&partnerID=8YFLogxK

U2 - 10.1016/j.amjcard.2014.05.027

DO - 10.1016/j.amjcard.2014.05.027

M3 - Article

VL - 114

SP - 534

EP - 540

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 4

ER -