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Impact of intravascular ultrasound guidance on long-term clinical outcomes in patients treated with drug-eluting stent for bifurcation lesions: data from a Korean multicenter bifurcation registry.

Authors
 Jung-Sun Kim  ;  Myeong-Ki Hong  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Jung Han Yoon  ;  Seung-Hyuk Choi  ;  Joo-Yong Hahn  ;  Hyeon-Cheol Gwon  ;  Myung-Ho Jeong  ;  Hyo-Soo Kim  ;  In-Whan Seong  ;  Joo-Young Yang  ;  Seung Woon Rha  ;  Seung-Jea Tahk  ;  Ki Bae Seung  ;  Seung-Jung Park  ;  Yangsoo Jang 
Citation
 American Heart Journal, Vol.161(1) : 180-187, 2011 
Journal Title
 American Heart Journal 
ISSN
 0002-8703 
Issue Date
2011
Abstract
BACKGROUND: although intravascular ultrasound (IVUS) has been widely used for complex lesions during coronary intervention, IVUS for stenting at bifurcation lesions has not been sufficiently assessed. The aim of this study was to investigate the impact of IVUS guidance on long-term clinical outcomes during drug-eluting stent (DES) implantation for bifurcation lesions. METHODS: the Korean multicenter bifurcation registry listed 1,668 patients with non-left main de novo bifurcation lesions who underwent DES implantation between January 2004 and June 2006. Using propensity score matching with clinical and angiographic characteristics, 487 patients with IVUS guidance and 487 patients with angiography guidance were selected. The long-term clinical outcomes were compared between the 2 groups. RESULTS: baseline clinical and angiographic characteristics were well matched and showed no significant differences between the 2 groups. Two-stent technique and final kissing ballooning angioplasty were more frequently performed in the IVUS-guided group. Maximal stent diameters at both the main vessel and the side branch were larger in the IVUS-guided group. Periprocedural creatine kinase-MB elevation (>3 times of upper normal limits) was frequently observed in the angiography-guided group. The incidence of death or myocardial infarction was significantly lower in the IVUS-guided group compared to the angiography-guided group (3.8% vs 7.8%, log rank test P = .03, hazard ratio 0.44, 95% CI 0.12-0.96, Cox model P = .04). CONCLUSIONS: intravascular ultrasound guidance during DES implantation at bifurcation lesions may be helpful to improve long-term clinical outcomes by reducing the occurrence of death or myocardial infarction.
Full Text
http://www.sciencedirect.com/science/article/pii/S0002870310009002
DOI
10.1016/j.ahj.2010.10.002
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
고영국(Ko, Young Guk) ORCID logo https://orcid.org/0000-0001-7748-5788
김중선(Kim, Jung Sun) ORCID logo https://orcid.org/0000-0003-2263-3274
장양수(Jang, Yang Soo) ORCID logo https://orcid.org/0000-0002-2169-3112
최동훈(Choi, Dong Hoon) ORCID logo https://orcid.org/0000-0002-2009-9760
홍명기(Hong, Myeong Ki) ORCID logo https://orcid.org/0000-0002-2090-2031
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/92693
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