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Association between angiographic and intravascular ultrasound optimizations after new-generation drug-eluting stent implantation and clinical outcomes

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dc.contributor.author고영국-
dc.contributor.author김대훈-
dc.contributor.author김병극-
dc.contributor.author김중선-
dc.contributor.author안철민-
dc.contributor.author장양수-
dc.contributor.author차정준-
dc.contributor.author최동훈-
dc.contributor.author홍명기-
dc.contributor.author홍성진-
dc.date.accessioned2021-10-21T00:11:33Z-
dc.date.available2021-10-21T00:11:33Z-
dc.date.issued2021-09-
dc.identifier.issn0954-6928-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/185416-
dc.description.abstractBackground: Uncertainty remains regarding the associations of angiographic optimization and intravascular ultrasound (IVUS) optimization after new-generation drug-eluting stent (DES) implantation. Methods: From four randomized trials comparing outcomes between IVUS and angiography-guidance for long or chronic total occlusion (CTO) lesions, 1396 patients who underwent IVUS-guided new-generation DES implantation were enrolled. Of these, 1112 patients (80%) met angiographic optimization criteria (postprocedural diameter stenosis, ≤20%) and were further classified into the matched (same results for angiographic optimization and IVUS optimization) and the mismatched group (opposite results for angiographic optimization and IVUS optimization) according to the meeting of IVUS optimization criteria (minimal stent area, ≥5.5 mm2 or ≥80% of mean reference lumen area). The major adverse clinical events (MACE) were compared. Results: Of 1112 patients with angiographic optimization, 675 patients met the IVUS optimization criteria (61%; matched), but 437 patients (39%; mismatched) failed to meet IVUS optimization criteria (false-positive rate = 76%). On multivariate analyses, age >60 years, reference vessel diameter ≤2.7 mm, left circumflex artery and lesion length ≥33 mm were significant predictors for the mismatched. When comparing the 12-month MACE rates, the mismatched group (6.8%) showed a significantly higher rate than the matched group (1.5%; hazard ratio = 2.62; 95% confidence interval = 1.20-5.72; P = 0.012), mainly driven by a higher target-vessel revascularization rate (6.4 vs 1.4%; P = 0.021). Conclusion: Despite meeting angiographic optimization criteria in long or CTO lesions, more than one-third of the patients with IVUS-guided new-generation DES implantation failed to meet the IVUS optimization criteria and had worse clinical outcomes. Therefore, IVUS optimization should be considered for patients who had predictors of mismatch.-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherLippincott Williams & Wilkins-
dc.relation.isPartOfCORONARY ARTERY DISEASE-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.titleAssociation between angiographic and intravascular ultrasound optimizations after new-generation drug-eluting stent implantation and clinical outcomes-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorJung-Joon Cha-
dc.contributor.googleauthorDaehoon Kim-
dc.contributor.googleauthorByeong-Keuk Kim-
dc.contributor.googleauthorSung-Jin Hong-
dc.contributor.googleauthorChul-Min Ahn-
dc.contributor.googleauthorJung-Sun Kim-
dc.contributor.googleauthorYoung-Guk Ko-
dc.contributor.googleauthorDonghoon Choi-
dc.contributor.googleauthorMyeong-Ki Hong-
dc.contributor.googleauthorYangsoo Jang-
dc.identifier.doi10.1097/MCA.0000000000001007-
dc.contributor.localIdA00127-
dc.contributor.localIdA00373-
dc.contributor.localIdA00493-
dc.contributor.localIdA00961-
dc.contributor.localIdA02269-
dc.contributor.localIdA03448-
dc.contributor.localIdA04851-
dc.contributor.localIdA04053-
dc.contributor.localIdA04391-
dc.contributor.localIdA04403-
dc.relation.journalcodeJ00649-
dc.identifier.eissn1473-5830-
dc.identifier.pmid33471477-
dc.identifier.urlhttps://journals.lww.com/coronary-artery/Fulltext/2021/09000/Association_between_angiographic_and_intravascular.8.aspx-
dc.contributor.alternativeNameKo, Young Guk-
dc.contributor.affiliatedAuthor고영국-
dc.contributor.affiliatedAuthor김대훈-
dc.contributor.affiliatedAuthor김병극-
dc.contributor.affiliatedAuthor김중선-
dc.contributor.affiliatedAuthor안철민-
dc.contributor.affiliatedAuthor장양수-
dc.contributor.affiliatedAuthor차정준-
dc.contributor.affiliatedAuthor최동훈-
dc.contributor.affiliatedAuthor홍명기-
dc.contributor.affiliatedAuthor홍성진-
dc.citation.volume32-
dc.citation.number6-
dc.citation.startPage541-
dc.citation.endPage548-
dc.identifier.bibliographicCitationCORONARY ARTERY DISEASE, Vol.32(6) : 541-548, 2021-09-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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