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Effect of Intravascular Ultrasound-Guided vs Angiography-Guided Everolimus-Eluting Stent Implantation: The IVUS-XPL Randomized Clinical Trial

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dc.contributor.author고영국-
dc.contributor.author권혁문-
dc.contributor.author김병극-
dc.contributor.author김중선-
dc.contributor.author남정모-
dc.contributor.author신동호-
dc.contributor.author장양수-
dc.contributor.author최동훈-
dc.contributor.author홍명기-
dc.contributor.author홍범기-
dc.contributor.author홍성진-
dc.date.accessioned2018-03-26T16:45:19Z-
dc.date.available2018-03-26T16:45:19Z-
dc.date.issued2015-
dc.identifier.issn0098-7484-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/156788-
dc.description.abstractIMPORTANCE: Use of intravascular ultrasound (IVUS) promotes better clinical outcomes for coronary intervention in complex coronary lesions. However, randomized data demonstrating the clinical usefulness of IVUS are limited for lesions treated with drug-eluting stents. OBJECTIVE: To determine whether the long-term clinical outcomes with IVUS-guided drug-eluting stent implantation are superior to those with angiography-guided implantation in patients with long coronary lesions. DESIGN, SETTING, AND PARTICIPANTS: The Impact of Intravascular Ultrasound Guidance on Outcomes of Xience Prime Stents in Long Lesions (IVUS-XPL) randomized, multicenter trial was conducted in 1400 patients with long coronary lesions (implanted stent ≥28 mm in length) between October 2010 and July 2014 at 20 centers in Korea. INTERVENTIONS: Patients were randomly assigned to receive IVUS-guided (n = 700) or angiography-guided (n = 700) everolimus-eluting stent implantation. MAIN OUTCOMES AND MEASURES: Primary outcome measure was the composite of major adverse cardiac events, including cardiac death, target lesion-related myocardial infarction, or ischemia-driven target lesion revascularization at 1 year, analyzed by intention-to-treat. RESULTS: One-year follow-up was complete in 1323 patients (94.5%). Major adverse cardiac events at 1 year occurred in 19 patients (2.9%) undergoing IVUS-guided and in 39 patients (5.8%) undergoing angiography-guided stent implantation (absolute difference, -2.97% [95% CI, -5.14% to -0.79%]) (hazard ratio [HR], 0.48 [95% CI, 0.28 to 0.83], P = .007). The difference was driven by a lower risk of ischemia-driven target lesion revascularization in patients undergoing IVUS-guided (17 [2.5%]) compared with angiography-guided (33 [5.0%]) stent implantation (HR, 0.51 [95% CI, 0.28 to 0.91], P = .02). Cardiac death and target lesion-related myocardial infarction were not significantly different between the 2 groups. For cardiac death, there were 3 patients (0.4%) in the IVUS-guided group and 5 patients (0.7%) in the angiography-guided group (HR, 0.60 [95% CI, 0.14 to 2.52], P = .48). Target lesion-related myocardial infarction occurred in 1 patient (0.1%) in the angiography-guided stent implantation group (P = .32). CONCLUSIONS AND RELEVANCE: Among patients requiring long coronary stent implantation, the use of IVUS-guided everolimus-eluting stent implantation, compared with angiography-guided stent implantation, resulted in a significantly lower rate of the composite of major adverse cardiac events at 1 year. These differences were primarily due to lower risk of target lesion revascularization.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherAmerican Medical Association-
dc.relation.isPartOfJAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.subject.MESHAged-
dc.subject.MESHCoronary Angiography/adverse effects-
dc.subject.MESHCoronary Angiography/methods*-
dc.subject.MESHCoronary Angiography/mortality-
dc.subject.MESHDrug-Eluting Stents*/adverse effects-
dc.subject.MESHEndovascular Procedures/adverse effects-
dc.subject.MESHEndovascular Procedures/methods*-
dc.subject.MESHEndovascular Procedures/mortality-
dc.subject.MESHEverolimus/administration & dosage*-
dc.subject.MESHFemale-
dc.subject.MESHFollow-Up Studies-
dc.subject.MESHHumans-
dc.subject.MESHImmunosuppressive Agents/administration & dosage*-
dc.subject.MESHMale-
dc.subject.MESHMiddle Aged-
dc.subject.MESHOutcome Assessment (Health Care)-
dc.subject.MESHProsthesis Implantation/methods*-
dc.subject.MESHProsthesis Implantation/mortality-
dc.subject.MESHRadiography, Interventional*/adverse effects-
dc.subject.MESHRadiography, Interventional*/mortality-
dc.subject.MESHUltrasonography, Interventional*/adverse effects-
dc.subject.MESHUltrasonography, Interventional*/mortality-
dc.titleEffect of Intravascular Ultrasound-Guided vs Angiography-Guided Everolimus-Eluting Stent Implantation: The IVUS-XPL Randomized Clinical Trial-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine-
dc.contributor.departmentDept. of Internal Medicine-
dc.contributor.googleauthorSung-Jin Hong-
dc.contributor.googleauthorByeong-Keuk Kim-
dc.contributor.googleauthorDong-Ho Shin-
dc.contributor.googleauthorChung-Mo Nam-
dc.contributor.googleauthorJung-Sun Kim-
dc.contributor.googleauthorYoung-Guk Ko-
dc.contributor.googleauthorDonghoon Choi-
dc.contributor.googleauthorTae-Soo Kang-
dc.contributor.googleauthorWoong-Chol Kang-
dc.contributor.googleauthorAe-Young Her-
dc.contributor.googleauthorYong Hoon Kim-
dc.contributor.googleauthorSeung-Ho Hur-
dc.contributor.googleauthorBum-Kee Hong-
dc.contributor.googleauthorHyuckmoon Kwon-
dc.contributor.googleauthorYangsoo Jang-
dc.contributor.googleauthorMyeong-Ki Hong-
dc.identifier.doi10.1001/jama.2015.15454-
dc.contributor.localIdA00127-
dc.contributor.localIdA00260-
dc.contributor.localIdA00493-
dc.contributor.localIdA00961-
dc.contributor.localIdA01264-
dc.contributor.localIdA02097-
dc.contributor.localIdA03448-
dc.contributor.localIdA04053-
dc.contributor.localIdA04391-
dc.contributor.localIdA04394-
dc.contributor.localIdA04403-
dc.relation.journalcodeJ01196-
dc.identifier.eissn1538-3598-
dc.identifier.pmid26556051-
dc.identifier.urlhttps://jamanetwork.com/journals/jama/fullarticle/2469205-
dc.contributor.alternativeNameKo, Young Guk-
dc.contributor.alternativeNameKwon, Hyuck Moon-
dc.contributor.alternativeNameKim, Byeong Keuk-
dc.contributor.alternativeNameKim, Jung Sun-
dc.contributor.alternativeNameNam, Jung Mo-
dc.contributor.alternativeNameShin, Dong Ho-
dc.contributor.alternativeNameJang, Yang Soo-
dc.contributor.alternativeNameChoi, Dong Hoon-
dc.contributor.alternativeNameHong, Myeong Ki-
dc.contributor.alternativeNameHong, Bum Kee-
dc.contributor.alternativeNameHong, Sung Jin-
dc.contributor.affiliatedAuthorKo, Young Guk-
dc.contributor.affiliatedAuthorKwon, Hyuck Moon-
dc.contributor.affiliatedAuthorKim, Byeong Keuk-
dc.contributor.affiliatedAuthorKim, Jung Sun-
dc.contributor.affiliatedAuthorNam, Jung Mo-
dc.contributor.affiliatedAuthorShin, Dong Ho-
dc.contributor.affiliatedAuthorJang, Yang Soo-
dc.contributor.affiliatedAuthorChoi, Dong Hoon-
dc.contributor.affiliatedAuthorHong, Myeong Ki-
dc.contributor.affiliatedAuthorHong, Bum Kee-
dc.contributor.affiliatedAuthorHong, Sung Jin-
dc.citation.volume314-
dc.citation.number20-
dc.citation.startPage2155-
dc.citation.endPage2163-
dc.identifier.bibliographicCitationJAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, Vol.314(20) : 2155-2163, 2015-
dc.identifier.rimsid39916-
dc.type.rimsART-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers

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