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Impact of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction and Chronic Kidney Disease

 Ji Woong Roh  ;  SungA Bae  ;  Thomas W Johnson  ;  Seok-Jae Heo  ;  Yongcheol Kim  ;  Deok-Kyu Cho  ;  Jung-Sun Kim  ;  Byeong-Keuk Kim  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang  ;  Myung Ho Jeong  ;  KAMIR-NIH Investigators 
 CIRCULATION JOURNAL, Vol.87(10) : 1339-1346, 2023-09 
Journal Title
Issue Date
Coronary Angiography ; Coronary Artery Disease* ; Humans ; Kidney Failure, Chronic* ; Myocardial Infarction* / diagnostic imaging ; Myocardial Infarction* / surgery ; Percutaneous Coronary Intervention* / methods ; Prospective Studies ; Renal Insufficiency, Chronic* / complications ; Treatment Outcome ; Ultrasonography, Interventional / methods
Acute myocardial infarction ; Chronic kidney disease ; End-stage renal disease ; Intravascular ultrasound ; Percutaneous coronary intervention
Background: In the setting of acute myocardial infarction (AMI), there are no data regarding the benefits of intravascular ultrasound (IVUS) for chronic kidney disease (CKD) patients.Methods and Results: This study used data from the Korea Acute Myocardial Infarction Registry, a large, multicenter prospective cohort. We evaluated 1,759 patients with AMI and CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and patients were classified into 2 groups: with and without IVUS. The primary outcome was target lesion failure (TLF) at 3 years. The hazard ratio (HR) of TLF according to eGFR was also analyzed. A total of 1,759 patients with AMI and CKD who underwent IVUS-guided PCI (19.2%) had a significantly lower risk of TLF at 3 years (8.9% vs. 15.3%; HR 0.55; 95% confidence interval [CI]: 0.38 to 0.81; P=0.002) than those who underwent angiography-guided PCI, regardless of their eGFR and the presence of end-stage renal disease (ESRD). The results were consistent after confounder adjustment and inversed probability weighting.

Conclusions: In patients with CKD and AMI who underwent PCI with 2nd-generation DES implantation, the use of IVUS guidance was associated with a significant reduction in 3-year TLF and showed consistently favorable outcomes regardless of eGFR and ESRD.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Yongcheol(김용철) ORCID logo https://orcid.org/0000-0001-5568-4161
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Roh, Ji Woong(노지웅)
Bae, SungA(배성아) ORCID logo https://orcid.org/0000-0003-1484-4645
Cho, Deok Kyu(조덕규)
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
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