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Kim YH, Her AY, Rha SW, Choi BG, Shim M, Choi SY, Byun JK, Li H, Kim W, Kang JH, Choi JY, Park EJ, Park SH, Lee S, Na JO, Choi CU, Lim HE, Kim EJ, Park CG, Seo HS, Oh DJ. Three-Year Major Clinical Outcomes of Angiography-Guided Single Stenting Technique in Non-Complex Left Main Coronary Artery Diseases. Int Heart J 2017; 58:704-713. [PMID: 28966331 DOI: 10.1536/ihj.17-115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
There is limited long-term comparative clinical outcome data concerning angiography- versus intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in non-complex left main coronary artery (LMCA) disease treated with the single stenting technique in the drug-eluting stent (DES) era.The aim of this study was to investigate whether angiography-guided stenting is comparable to IVUS-guided stenting during 3-year clinical follow-up periods in patients with non-complex LM disease treated with the single stenting technique.A total of 196 patients treated with either angiography-guided (n = 74) or IVUS-guided (n = 122) PCI were included. The primary outcome was the occurrence of major adverse cardiac events (MACE) defined as total death, non-fatal myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and non-target vessel revascularization (Non-TVR). To adjust for any potential confounders, propensity score (PS) adjusted analysis was performed.During 3-year follow-up, the PS adjusted Cox-proportional hazard ratio (HR) was not significantly different between the two groups for total death, cardiac death, and MI. Also, TLR and the combined rates of TVR and non-TVR were not significantly different. Finally, MACE was not significantly different between the two groups (HR: 0.63, 95% Confidence interval (CI): 0.33-1.17; P = 0.149).Angiography-guided PCI for non-complex LMCA diseases treated with the single stenting technique showed comparable results compared with IVUS-guided PCI in reducing clinical events during 3-year clinical follow-up in the DES era. Although IVUS guided PCI is the ideal strategy, angiography-guided PCI can be an option for LMCA PCI in some selected cases.
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Affiliation(s)
- Yong Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine
| | - Ae-Young Her
- Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine
| | - Seung-Woon Rha
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | | | - Minsuk Shim
- Department of Medicine, Korea University Graduate School
| | - Se Yeon Choi
- Department of Medicine, Korea University Graduate School
| | | | - Hu Li
- Department of Medicine, Korea University Graduate School
| | - Woohyeun Kim
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Jun Hyuk Kang
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Jah Yeon Choi
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Eun Jin Park
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Sung Hun Park
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Sunki Lee
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Jin Oh Na
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Cheol Ung Choi
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Hong Euy Lim
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Eung Ju Kim
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Chang Gyu Park
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Hong Seog Seo
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
| | - Dong Joo Oh
- Department of Medicine, Korea University Graduate School.,Cardiovascular Center, Korea University Guro Hospital
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