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Clinical Implications of Poststent Optical Coherence Tomographic Findings: Severe Malapposition and Cardiac Events

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dc.contributor.author고영국-
dc.contributor.author김병극-
dc.contributor.author김인수-
dc.contributor.author김중선-
dc.contributor.author신동호-
dc.contributor.author안철민-
dc.contributor.author이승준-
dc.contributor.author이오현-
dc.contributor.author이용준-
dc.contributor.author장양수-
dc.contributor.author최동훈-
dc.contributor.author홍성진-
dc.date.accessioned2022-03-11T06:21:56Z-
dc.date.available2022-03-11T06:21:56Z-
dc.date.issued2022-01-
dc.identifier.issn1936-878X-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/188054-
dc.description.abstractObjectives: This study sought to evaluate the impact of poststent optical coherence tomography (OCT) findings, including severe malapposition, on long-term clinical outcomes. Background: Suboptimal OCT findings following percutaneous coronary intervention (PCI) are highly prevalent; however, their clinical implications remain controversial. Methods: Of the patients registered in the Yonsei OCT registry, a total of 1,290 patients with 1,348 lesions, who underwent OCT immediately poststenting, were consecutively enrolled for this study. All patients underwent implantation of drug-eluting stents. Poststent OCT findings were assessed to identify predictors of device-oriented clinical endpoints (DoCE), including cardiac death, target vessel-related myocardial infarction (MI) or stent thrombosis, and target lesion revascularization (TLR). Significant malapposition criteria associated with major safety events (MSE) were also investigated, such as cardiac death, target vessel-related MI, or stent thrombosis. Results: The median follow-up period was 43.0 months (interquartile range [IQR] 21.4 to 56.0 months). The incidence rates of stent edge dissection, tissue prolapse, thrombus, and malapposition after intervention were not associated with occurrence of DoCE. However, patients with significant malapposition (total malapposition volume [TMV] ≥7.0 mm3] exhibited more frequent MSE. A smaller minimal stent area (MSA) was identified as an independent predictor for DoCE (hazard ratio [HR]: 1.20 [95% confidence interval [CI]: 1.00 to 1.43]; p = 0.045). Malapposition with TMV ≥7.0 mm3 was found to be an independent predictor of MSE (HR: 6.12 [95% CI: 1.88 to 19.95]; p = 0.003). Follow-up OCT at 3, 6, or 9 months after PCI showed that poststent TMV ≥7.0 mm3 was related to a greater occurrence of late malapposition and uncovered struts. Conclusions: Although most suboptimal OCT findings were not associated with clinical outcomes, a smaller MSA was associated with DoCE, driven mainly by TLR, and significant malapposition with TMV ≥7.0 mm3 was associated with more MSE after PCI. (Yonsei OCT [Optical Coherence Tomography] Registry for Evaluation of Efficacy and Safety of Coronary Stenting; Yonsei OCT registry; NCT02099162).-
dc.description.statementOfResponsibilityrestriction-
dc.languageEnglish-
dc.publisherElsevier-
dc.relation.isPartOfJACC-CARDIOVASCULAR IMAGING-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.subject.MESHCoronary Angiography-
dc.subject.MESHCoronary Artery Disease* / diagnostic imaging-
dc.subject.MESHCoronary Artery Disease* / therapy-
dc.subject.MESHCoronary Vessels / diagnostic imaging-
dc.subject.MESHCoronary Vessels / surgery-
dc.subject.MESHHumans-
dc.subject.MESHPercutaneous Coronary Intervention* / adverse effects-
dc.subject.MESHPredictive Value of Tests-
dc.subject.MESHTomography, Optical Coherence / methods-
dc.subject.MESHTreatment Outcome-
dc.titleClinical Implications of Poststent Optical Coherence Tomographic Findings: Severe Malapposition and Cardiac Events-
dc.typeArticle-
dc.contributor.collegeCollege of Medicine (의과대학)-
dc.contributor.departmentDept. of Internal Medicine (내과학교실)-
dc.contributor.googleauthorByung Gyu Kim-
dc.contributor.googleauthorMateusz Kachel-
dc.contributor.googleauthorJung-Sun Kim-
dc.contributor.googleauthorGiulio Guagliumi-
dc.contributor.googleauthorChoongki Kim-
dc.contributor.googleauthorIn-Soo Kim-
dc.contributor.googleauthorYong-Joon Lee-
dc.contributor.googleauthorOh-Hyun Lee-
dc.contributor.googleauthorYoung Sup Byun-
dc.contributor.googleauthorByung Ok Kim-
dc.contributor.googleauthorKrzysztof Milewski-
dc.contributor.googleauthorSeung-Jun Lee-
dc.contributor.googleauthorSung-Jin Hong-
dc.contributor.googleauthorChul-Min Ahn-
dc.contributor.googleauthorDong-Ho Shin-
dc.contributor.googleauthorByeong-Keuk Kim-
dc.contributor.googleauthorYoung-Guk Ko-
dc.contributor.googleauthorDonghoon Choi-
dc.contributor.googleauthorYangsoo Jang-
dc.identifier.doi10.1016/j.jcmg.2021.03.008-
dc.contributor.localIdA00127-
dc.contributor.localIdA00493-
dc.contributor.localIdA00840-
dc.contributor.localIdA00961-
dc.contributor.localIdA02097-
dc.contributor.localIdA02269-
dc.contributor.localIdA02927-
dc.contributor.localIdA05164-
dc.contributor.localIdA02984-
dc.contributor.localIdA03448-
dc.contributor.localIdA04053-
dc.contributor.localIdA04403-
dc.relation.journalcodeJ01192-
dc.identifier.eissn1876-7591-
dc.identifier.pmid34023255-
dc.identifier.urlhttps://www.sciencedirect.com/science/article/pii/S1936878X21002680-
dc.subject.keyworddrug-eluting stent(s)-
dc.subject.keywordmalapposition-
dc.subject.keywordoptical coherence tomography-
dc.subject.keywordpercutaneous coronary intervention-
dc.subject.keywordtotal malapposition volume-
dc.contributor.alternativeNameKo, Young Guk-
dc.contributor.affiliatedAuthor고영국-
dc.contributor.affiliatedAuthor김병극-
dc.contributor.affiliatedAuthor김인수-
dc.contributor.affiliatedAuthor김중선-
dc.contributor.affiliatedAuthor신동호-
dc.contributor.affiliatedAuthor안철민-
dc.contributor.affiliatedAuthor이승준-
dc.contributor.affiliatedAuthor이오현-
dc.contributor.affiliatedAuthor이용준-
dc.contributor.affiliatedAuthor장양수-
dc.contributor.affiliatedAuthor최동훈-
dc.contributor.affiliatedAuthor홍성진-
dc.citation.volume15-
dc.citation.number1-
dc.citation.startPage126-
dc.citation.endPage137-
dc.identifier.bibliographicCitationJACC-CARDIOVASCULAR IMAGING, Vol.15(1) : 126-137, 2022-01-
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers

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