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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.

 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 
 AMERICAN HEART JOURNAL, Vol.161(1) : 180-187, 2011 
Journal Title
Issue Date
Coronary Stenosis/diagnostic imaging* ; Coronary Stenosis/mortality ; Coronary Stenosis/surgery ; Drug-Eluting Stents* ; Female ; Follow-Up Studies ; Humans ; Korea/epidemiology ; Male ; Middle Aged ; Prognosis ; Reproducibility of Results ; Retrospective Studies ; Survival Rate/trends ; Time Factors ; Treatment Outcome ; Ultrasonography, Interventional/methods*
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.
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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, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
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
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