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Optical coherence tomography derived cut-off value of uncovered stent struts to predict adverse clinical outcomes after drug-eluting stent implantation

Authors
 Hoyoun Won  ;  Dong-Ho Shin  ;  Byeong-Keuk Kim  ;  Gary S. Mintz  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Yangsoo Jang  ;  Myeong-Ki Hong 
Citation
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING, Vol.29(6) : 1255-1263, 2013 
Journal Title
 INTERNATIONAL JOURNAL OF CARDIOVASCULAR IMAGING 
ISSN
 1569-5794 
Issue Date
2013
MeSH
Aged ; Area Under Curve ; Chi-Square Distribution ; Coronary Angiography ; Coronary Artery Disease/diagnostic imaging ; Coronary Artery Disease/mortality ; Coronary Artery Disease/pathology ; Coronary Artery Disease/therapy* ; Coronary Thrombosis/etiology ; Coronary Thrombosis/pathology ; Coronary Vessels/diagnostic imaging ; Coronary Vessels/pathology* ; Drug-Eluting Stents* ; Female ; Humans ; Male ; Middle Aged ; Multivariate Analysis ; Myocardial Infarction/etiology ; Myocardial Infarction/pathology ; Odds Ratio ; Percutaneous Coronary Intervention/adverse effects* ; Percutaneous Coronary Intervention/instrumentation* ; Percutaneous Coronary Intervention/mortality ; Predictive Value of Tests ; Proportional Hazards Models ; Prosthesis Design ; ROC Curve ; Registries ; Risk Factors ; Time Factors ; Tomography, Optical Coherence* ; Treatment Outcome
Keywords
Optical coherence tomography ; Drug-eluting stent ; Coronary artery disease
Abstract
Although the presence of uncovered struts may be associated with occurrence of stent thrombosis, the impact of uncovered struts detected routinely by optical coherence tomography (OCT) on subsequent long-term clinical outcomes remains unclear. The objective of this study was to determine the cut-off value of uncovered struts that predicted adverse clinical outcomes after drug eluting stent (DES) implantation. Major safety events (MSEs, a composite occurrence of cardiovascular death, myocardial infarction, and stent thrombosis) were evaluated in 489 DES-treated patients (535 lesions) during the median 851 days after follow-up OCT. MSEs occurred in six patients (four definite stent thrombosis and two sudden cardiac death). The best cut-off value of percentage of uncovered struts for predicting MSE was 5.9 % using the maximal χ(2) method: area under the receiver-operating characteristic curve = 0.779, 95 % confidence interval (CI) = 0.648-0.910, p = 0.019, a sensitivity of 83.3 % and a specificity of 70.3 %. Independent predictors for MSE were post-intervention minimal lumen diameter (odds ratio 0.019, 95 % CI = 0.001-0.513, p = 0.018) and percentage of uncovered struts ≥5.9 % (odds ratio 19.781, 95 % CI = 2.071-188.968, p = 0.010). A greater percentage of uncovered struts (the cut-off value of ≥5.9 % uncovered struts) might be significantly associated with occurrence of MSE after DES implantation.
Full Text
http://link.springer.com/article/10.1007%2Fs10554-013-0223-9
DOI
10.1007/s10554-013-0223-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Shin, Dong Ho(신동호) ORCID logo https://orcid.org/0000-0002-7874-5542
Won, Ho Youn(원호연)
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
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
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87369
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