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Intravascular Ultrasound Predictors of Major Adverse Cardiovascular Events After Implantation of Everolimus-eluting Stents for Long Coronary Lesions.

Authors
 Seung-Yul Lee  ;  Dong-Ho Shin  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
Citation
 REVISTA ESPANOLA DE CARDIOLOGIA, Vol.70(2) : 88-95, 2017 
Journal Title
 REVISTA ESPANOLA DE CARDIOLOGIA 
ISSN
 0300-8932 
Issue Date
2017
MeSH
Aged ; Cause of Death/trends ; Coronary Angiography ; Coronary Restenosis/diagnosis* ; Coronary Restenosis/epidemiology ; Coronary Restenosis/etiology ; Coronary Stenosis/diagnosis ; Coronary Stenosis/surgery ; Coronary Vessels/diagnostic imaging* ; Coronary Vessels/surgery ; Everolimus/pharmacology* ; Female ; Follow-Up Studies ; Humans ; Immunosuppressive Agents/pharmacology ; Incidence ; Male ; Middle Aged ; Percutaneous Coronary Intervention/adverse effects* ; Postoperative Complications/diagnosis* ; Postoperative Complications/epidemiology ; Postoperative Complications/etiology ; Predictive Value of Tests ; Prognosis ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Factors ; Survival Rate/trends ; Time Factors ; Ultrasonography, Interventional/methods*
Keywords
Coronary artery disease ; Drug-eluting stent ; Ecocardiografía intravascular ; Enfermedad coronaria ; Intravascular ultrasound ; Stent farmacoactivo
Abstract
INTRODUCTION AND OBJECTIVES: There are limited data on the usefulness of intravascular ultrasound (IVUS) for long coronary lesions treated with second-generation drug-eluting stents. We evaluated IVUS predictors of major adverse cardiovascular events (MACE) 12 months after implantation of everolimus-eluting stents for long coronary lesions. METHODS: A total of 804 patients who underwent both postintervention IVUS examination and long everolimus-eluting stent (≥ 28mm in length) implantation were included from 2 randomized trials. MACE was defined as a composite of cardiac death, myocardial infarction, and target-lesion revascularization. RESULTS: MACE occurred in 24 patients (3.0%) over 12 months. On multivariable Cox regression analysis, independent IVUS predictors of MACE included the postintervention minimum lumen area (MLA) at the target lesion (HR = 0.623; 95%CI, 0.433-0.895; P=.010) and the ratio of MLA/distal reference segment lumen area (HR = 0.744; 95%CI, 0.572-0.969; P=.028). The MLA and MLA-to-distal reference segment lumen area ratio that best predicted patients with MACE from those without these events were 5.0 mm2 and 1.0, respectively. Patients with MLA<5.0 mm2 or a distal reference segment lumen area had a higher risk of MACE (HR = 6.231; 95%CI, 1.859-20.891; P=.003) than those without MACE. CONCLUSIONS: Patients with a postintervention IVUS-measured MLA of<5.0 mm2 or a distal reference segment lumen area were at risk for MACE after long everolimus-eluting stent implantation.
Full Text
http://www.revespcardiol.org/en/pdf/90460596/S300/
DOI
10.1016/j.rec.2016.06.019
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154181
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