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Effect of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation: 5-Year Follow-Up of the IVUS-XPL Randomized Trial

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dc.contributor.author고영국-
dc.contributor.author권혁문-
dc.contributor.author김병극-
dc.contributor.author김중선-
dc.contributor.author안철민-
dc.contributor.author장양수-
dc.contributor.author최동훈-
dc.contributor.author홍명기-
dc.contributor.author홍범기-
dc.contributor.author홍성진-
dc.date.accessioned2020-02-11T06:52:17Z-
dc.date.available2020-02-11T06:52:17Z-
dc.date.issued2020-
dc.identifier.issn1936-8798-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/174883-
dc.description.abstractOBJECTIVES: The goal of this study was to evaluate whether the beneficial effect of use of intravascular ultrasound (IVUS) is sustained for long-term follow-up. BACKGROUND: The use of IVUS promoted favorable 1-year clinical outcome in the IVUS-XPL (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions) trial. It is not known, however, whether this effect is sustained for long-term follow-up. METHODS: The IVUS-XPL trial randomized 1,400 patients with long coronary lesions (implanted stent length ≥28 mm) to receive IVUS-guided (n = 700) or angiography-guided (n = 700) everolimus-eluting stent implantation. Five-year clinical outcomes were investigated in patients who completed the original trial. The primary outcome was the composite of major adverse cardiac events, including cardiac death, target lesion-related myocardial infarction, or ischemia-driven target lesion revascularization at 5 years, analyzed by intention-to-treat. RESULTS: Five-year follow-up was completed in 1,183 patients (85%). Major adverse cardiac events at 5 years occurred in 36 patients (5.6%) receiving IVUS guidance and in 70 patients (10.7%) receiving angiographic guidance (hazard ratio: 0.50; 95% confidence interval: 0.34 to 0.75; p = 0.001). The difference was driven mainly by a lower risk for target lesion revascularization (31 [4.8%] vs. 55 [8.4%]; hazard ratio: 0.54; 95% confidence interval: 0.33 to 0.89; p = 0.007). By landmark analysis, major adverse cardiac events between 1 and 5 years occurred in 17 patients (2.8%) receiving IVUS guidance and in 31 patients (5.2%) receiving angiographic guidance (hazard ratio: 0.53; 95% confidence interval: 0.29 to 0.95; p = 0.031). CONCLUSIONS: Compared with angiography-guided stent implantation, IVUS-guided stent implantation resulted in a significantly lower rate of major adverse cardiac events up to 5 years. Sustained 5-year clinical benefits resulted from both within 1 year and from 1 to 5 years post-implantation. (Impact of Intravascular Ultrasound Guidance on the Outcomes of Xience Prime Stents in Long Lesions [IVUS-XPL Study]: Retrospective and Prospective Follow-Up Study; NCT03866486).-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier-
dc.relation.isPartOfJACC-CARDIOVASCULAR INTERVENTIONS-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleEffect of Intravascular Ultrasound-Guided Drug-Eluting Stent Implantation: 5-Year Follow-Up of the IVUS-XPL Randomized Trial-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorSung-Jin Hong-
dc.contributor.googleauthorGary S. Mintz-
dc.contributor.googleauthorChul-Min Ahn-
dc.contributor.googleauthorJung-Sun Kim-
dc.contributor.googleauthorByeong-Keuk Kim-
dc.contributor.googleauthorYoung-Guk Ko-
dc.contributor.googleauthorTae-Soo Kang-
dc.contributor.googleauthorWoong-Chol Kang-
dc.contributor.googleauthorYong Hoon Kim-
dc.contributor.googleauthorSeung-Ho Hur-
dc.contributor.googleauthorBum-Kee Hong-
dc.contributor.googleauthorDonghoon Choi-
dc.contributor.googleauthorHyuckmoon Kwon-
dc.contributor.googleauthorYangsoo Jang-
dc.contributor.googleauthorMyeong-Ki Hong-
dc.contributor.googleauthorIVUS-XPL Investigators-
dc.identifier.doi10.1016/j.jcin.2019.09.033-
dc.contributor.localIdA00127-
dc.contributor.localIdA00260-
dc.contributor.localIdA00493-
dc.contributor.localIdA00961-
dc.contributor.localIdA02269-
dc.contributor.localIdA03448-
dc.contributor.localIdA04053-
dc.contributor.localIdA04391-
dc.contributor.localIdA04394-
dc.contributor.localIdA04403-
dc.relation.journalcodeJ01193-
dc.identifier.eissn1876-7605-
dc.identifier.pmid31918944-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S1936879819320199-
dc.subject.keywordcoronary artery disease-
dc.subject.keyworddrug-eluting stent-
dc.subject.keywordintravascular ultrasound-
dc.contributor.alternativeNameKo, Young Guk-
dc.contributor.affiliatedAuthor고영국-
dc.contributor.affiliatedAuthor권혁문-
dc.contributor.affiliatedAuthor김병극-
dc.contributor.affiliatedAuthor김중선-
dc.contributor.affiliatedAuthor안철민-
dc.contributor.affiliatedAuthor장양수-
dc.contributor.affiliatedAuthor최동훈-
dc.contributor.affiliatedAuthor홍명기-
dc.contributor.affiliatedAuthor홍범기-
dc.contributor.affiliatedAuthor홍성진-
dc.citation.volume13-
dc.citation.number1-
dc.citation.startPage62-
dc.citation.endPage71-
dc.identifier.bibliographicCitationJACC-CARDIOVASCULAR INTERVENTIONS, Vol.13(1) : 62-71, 2020-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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