Information de reference pour ce titreAccession Number: | 01337495-201705000-00014.
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Author: | Andell, Pontus MD, PhD; Karlsson, Sofia MD; Mohammad, Moman A. MD; Gotberg, Matthias MD, PhD; James, Stefan MD, PhD; Jensen, Jens MD, PhD; Frobert, Ole MD, PhD; Angeras, Oskar MD, PhD; Nilsson, Johan MD, PhD; Omerovic, Elmir MD, PhD; Lagerqvist, Bo MD, PhD; Persson, Jonas MD, PhD; Koul, Sasha MD, PhD; Erlinge, David MD, PhD
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Institution: | From the Department of Cardiology, Clinical Sciences, Lund University, Skane University Hospital, Sweden (P.A., S.K., M.A.M., M.G., S.K., D.E.); Department of Medical Sciences, Uppsala University, Sweden (S.J., B.L.); Department of Clinical Science and Education, Sodersjukhuset, Karolinska Institutet, and Unit of Medicine, Capio St Gorans Sjukhus, Stockholm, Sweden (J.J.); Department of Cardiology, Faculty of Health, Orebro University, Sweden (O.F.); Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden (O.A., E.O.); University and Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden (O.A., E.O.); Department of Cardiology, Umea University Hospital, Heart Centre, Sweden (J.N.); and Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital, Stockholm, Sweden (J.P.).
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Title: | |
Source: | Circulation: Cardiovascular Interventions. 10(5):e004813, May 2017.
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Abstract: | Background-: Small observational studies have indicated better outcome with intravascular ultrasound (IVUS) guidance when performing unprotected left main coronary artery (LMCA) percutaneous coronary intervention (PCI), but the overall picture remains inconclusive and warrants further investigation. We studied the impact of IVUS guidance on outcome in patients undergoing unprotected LMCA PCI in a Swedish nationwide observational study.
Methods and Results-: Patients who underwent unprotected LMCA PCI between 2005 and 2014 because of stable coronary artery disease or acute coronary syndrome were included from the nationwide SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Of 2468 patients, IVUS guidance was used in 621 (25.2%). The IVUS group was younger (median age, 70 versus 75 years) and had fewer comorbidities but more complex lesions. IVUS was associated with larger stent diameters (median, 4 mm versus 3.5 mm). After adjusting for potential confounders, IVUS was associated with significantly lower occurrence of the primary composite end point of all-cause mortality, restenosis, or definite stent thrombosis (hazard ratio, 0.65; 95% confidence interval, 0.50-0.84) and all-cause mortality alone (hazard ratio, 0.62; 95% confidence interval, 0.47-0.82). In 340 propensity score-matched pairs, IVUS was also associated with significantly lower occurrence of the primary end point (hazard ratio, 0.54; 95% confidence interval, 0.37-0.80).
Conclusions-: IVUS was associated with an independent and significant outcome benefit when performing unprotected LMCA PCI. Potential mediators of this benefit include larger and more appropriately sized stents, perhaps translating into lower risk of subsequent stent thrombosis. Although residual confounding cannot be ruled out, our findings indicate a possible hazard when performing unprotected LMCA PCI without IVUS guidance.
(C) 2017 American Heart Association, Inc.
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Author Keywords: | acute coronary syndrome; angioplasty; comorbidity; percutaneous coronary intervention; thrombosis.
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References: | 1. Morice MC, Serruys PW, Kappetein AP, Feldman TE, Stahle E, Colombo A, Mack MJ, Holmes DR, Torracca L, van Es GA, Leadley K, Dawkins KD, Mohr F. Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the synergy between percutaneous coronary intervention with TAXUS and cardiac surgery (SYNTAX) trial. Circulation. 2010;121:2645-2653 doi: 10.1161/CIRCULATIONAHA.109.899211.
2. Park SJ, Kim YH, Park DW, Yun SC, Ahn JM, Song HG, Lee JY, Kim WJ, Kang SJ, Lee SW, Lee CW, Park SW, Chung CH, Lee JW, Lim DS, Rha SW, Lee SG, Gwon HC, Kim HS, Chae IH, Jang Y, Jeong MH, Tahk SJ, Seung KB. Randomized trial of stents versus bypass surgery for left main coronary artery disease. N Engl J Med. 2011;364:1718-1727 doi: 10.1056/NEJMoa1100452.
3. Park DW, Kim YH, Yun SC, Lee JY, Kim WJ, Kang SJ, Lee SW, Lee CW, Kim JJ, Choo SJ, Chung CH, Lee JW, Park SW, Park SJ. Long-term outcomes after stenting versus coronary artery bypass grafting for unprotected left main coronary artery disease: 10-year results of bare-metal stents and 5-year results of drug-eluting stents from the ASAN-MAIN (ASAN Medical Center-Left MAIN Revascularization) registry. J Am Coll Cardiol. 2010;56:1366-1375 doi: 10.1016/j.jacc.2010.03.097.
4. Stone GW, Sabik JF, Serruys PW, Simonton CA, Genereux P, Puskas J, Kandzari DE, Morice MC, Lembo N, Brown WM, Taggart DP, Banning A, Merkely B, Horkay F, Boonstra PW, van Boven AJ, Ungi I, Bogats G, Mansour S, Noiseux N, Sabate M, Pomar J, Hickey M, Gershlick A, Buszman P, Bochenek A, Schampaert E, Page P, Dressler O, Kosmidou I, Mehran R, Pocock SJ, Kappetein APEXCEL Trial Investigators. . Everolimus-eluting stents or bypass surgery for left main coronary artery disease. N Engl J Med. 2016;375:2223-2235 doi: 10.1056/NEJMoa1610227.
5. Makikallio T, Holm NR, Lindsay M, Spence MS, Erglis A, Menown IB, Trovik T, Eskola M, Romppanen H, Kellerth T, Ravkilde J, Jensen LO, Kalinauskas G, Linder RBA, Pentikainen M, Hervold A, Banning A, Zaman A, Cotton J, Eriksen E, Margus S, Sorensen HT, Nielsen PH, Niemela M, Kervinen K, Lassen JF, Maeng M, Oldroyd K, Berg G, Walsh SJ, Hanratty CG, Kumsars I, Stradins P, Steigen TK, Frobert O, Graham ANJ, Endresen PC, Corbascio M, Kajander O, Trivedi U, Hartikainen J, Anttila V, Hildick-Smith D, Thuesen L, Christiansen EHNOBLE Study Investigators. . Percutaneous coronary angioplasty versus coronary artery bypass grafting in treatment of unprotected left main stenosis (NOBLE): a prospective, randomised, open-label, non-inferiority trial. Lancet. 2016;388:2743-2752 doi: 10.1016/S0140-6736(16)32052-9.
6. Levine GN, Bates ER, Blankenship JC, Bailey SR, Bittl JA, Cercek B, Chambers CE, Ellis SG, Guyton RA, Hollenberg SM, Khot UN, Lange RA, Mauri L, Mehran R, Moussa ID, Mukherjee D, Nallamothu BK, Ting HH. 2011 ACCF/AHA/SCAI Guideline for percutaneous coronary intervention: executive summary: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions. Circulation. 2011;124:2574-2609 doi: 10.1161/CIR.0b013e31823a5596.
7. Windecker S, Kolh P, Alfonso F, Collet JP, Cremer J, Falk V, Filippatos G, Hamm C, Head SJ, Juni P, Kappetein AP, Kastrati A, Knuuti J, Landmesser U, Laufer G, Neumann FJ, Richter DJ, Schauerte P, Sousa Uva M, Stefanini GG, Taggart DP, Torracca L, Valgimigli M, Wijns W, Witkowski A. 2014 ESC/EACTS Guidelines on myocardial revascularization: the task force on myocardial revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS) developed with the special contribution of the European Association of Percutaneous Cardiovascular Interventions (EAPCI). Eur Heart J. 2014;35:2541-2619 doi: 10.1093/eurheartj/ehu278.
8. Choi SY, Witzenbichler B, Maehara A, Lansky AJ, Guagliumi G, Brodie B, Kellett MA, Dressler O, Parise H, Mehran R, Dangas GD, Mintz GS, Stone GW. Intravascular ultrasound findings of early stent thrombosis after primary percutaneous intervention in acute myocardial infarction: a harmonizing outcomes with revascularization and stents in acute myocardial infarction (HORIZONS-AMI) substudy. Circ Cardiovasc Interv. 2011;4:239-247 doi: 10.1161/CIRCINTERVENTIONS.110.959791.
9. Cheneau E, Leborgne L, Mintz GS, Kotani J, Pichard AD, Satler LF, Canos D, Castagna M, Weissman NJ, Waksman R. Predictors of subacute stent thrombosis: results of a systematic intravascular ultrasound study. Circulation. 2003;108:43-47 doi: 10.1161/01.CIR.0000078636.71728.40.
10. Fujii K, Carlier SG, Mintz GS, Yang YM, Moussa I, Weisz G, Dangas G, Mehran R, Lansky AJ, Kreps EM, Collins M, Stone GW, Moses JW, Leon MB. Stent underexpansion and residual reference segment stenosis are related to stent thrombosis after sirolimus-eluting stent implantation: an intravascular ultrasound study. J Am Coll Cardiol. 2005;45:995-998 doi: 10.1016/j.jacc.2004.12.066.
11. De Labriolle A, Bonello L, Lemesle G, Steinberg DH, Roy P, Xue Z, Kaneshige K, Suddath WO, Satler LF, Kent KM, Pichard AD, Lindsay J, Waksman R. Clinical presentation and outcome of patients hospitalized for symptomatic in-stent restenosis treated by percutaneous coronary intervention: comparison between drug-eluting stents and bare-metal stents. Arch Cardiovasc Dis. 2009;102:209-217 doi: 10.1016/j.acvd.2009.01.004.
12. Nissen SE, Yock P. Intravascular ultrasound: novel pathophysiological insights and current clinical applications. Circulation. 2001;103:604-616 doi: 10.1161/01.CIR.103.4.604.
13. Witzenbichler B, Maehara A, Weisz G, Neumann FJ, Rinaldi MJ, Metzger DC, Henry TD, Cox DA, Duffy PL, Brodie BR, Stuckey TD, Mazzaferri EL, Xu K, Parise H, Mehran R, Mintz GS, Stone GW. Relationship between intravascular ultrasound guidance and clinical outcomes after drug-eluting stents: the assessment of dual antiplatelet therapy with drug-eluting stents (ADAPT-DES) study. Circulation. 2014;129:463-470 doi: 10.1161/CIRCULATIONAHA.113.003942.
14. Fitzgerald PJ, Oshima A, Hayase M, Metz JA, Bailey SR, Baim DS, Cleman MW, Deutsch E, Diver DJ, Leon MB, Moses JW, Oesterle SN, Overlie PA, Pepine CJ, Safian RD, Shani J, Simonton CA, Smalling RW, Teirstein PS, Zidar JP, Yeung AC, Kuntz RE, Yock PG. Final results of the Can Routine Ultrasound Influence Stent Expansion (CRUISE) Study. Circulation. 2000;102:523-530 doi: 10.1161/01.CIR.102.5.523.
15. Hong SJ, Kim BK, Shin DH, Nam CM, Kim JS, Ko YG, Choi D, Kang TS, Kang WC, Her AY, Kim YH, Kim Y, Hur SH, Hong BK, Kwon H, Jang Y, Hong MKIVUS-XPL Investigators. . Effect of Intravascular Ultrasound-Guided vs Angiography-Guided Everolimus-Eluting Stent Implantation: The IVUS-XPL randomized clinical trial. JAMA. 2015;314:2155-2163 doi: 10.1001/jama.2015.15454.
16. Park SJ, Kim YH, Park DW, Lee SW, Kim WJ, Suh J, Yun SC, Lee CW, Hong MK, Lee JH, Park SWMAIN-COMPARE Investigators. . Impact of intravascular ultrasound guidance on long-term mortality in stenting for unprotected left main coronary artery stenosis. Circ Cardiovasc Interv. 2009;2:167-177 doi: 10.1161/CIRCINTERVENTIONS.108.799494.
17. de la Torre Hernandez JM, Baz Alonso JA, Gomez Hospital JA, Alfonso Manterola F, Garcia Camarero T, Gimeno de Carlos F, Roura Ferrer G, Recalde AS, Martinez-Luengas IL, Gomez Lara J, Hernandez Hernandez F, Perez-Vizcayno MJ, Cequier Fillat A, Perez de Prado A, Gonzalez-Trevilla AA, Jimenez Navarro MF, Mauri Ferre J, Fernandez Diaz JA, Pinar Bermudez E, Zueco Gil J. Clinical impact of intravascular ultrasound guidance in drug-eluting stent implantation for unprotected left main coronary disease: pooled analysis at the patient-level of 4 registries. JACC Cardiovasc Interv. 2014;7:244-254 doi: 10.1016/j.jcin.2013.09.014.
18. Zhang YJ, Pang S, Chen XY, Bourantas CV, Pan DR, Dong SJ, Wu W, Ren XM, Zhu H, Shi SY, Iqbal J, Gogas BD, Xu B, Chen SL. Comparison of intravascular ultrasound guided versus angiography guided drug eluting stent implantation: a systematic review and meta-analysis. BMC Cardiovasc Disord. 2015;15:153 doi: 10.1186/s12872-015-0144-8.
19. Agostoni P, Valgimigli M, Van Mieghem CA, Rodriguez-Granillo GA, Aoki J, Ong AT, Tsuchida K, McFadden EP, Ligthart JM, Smits PC, de Jaegere P, Sianos G, Van der Giessen WJ, De Feyter P, Serruys PW. Comparison of early outcome of percutaneous coronary intervention for unprotected left main coronary artery disease in the drug-eluting stent era with versus without intravascular ultrasonic guidance. Am J Cardiol. 2005;95:644-647 doi: 10.1016/j.amjcard.2004.10.042.
20. Tan Q, Wang Q, Liu D, Zhang S, Zhang Y, Li Y. Intravascular ultrasound-guided unprotected left main coronary artery stenting in the elderly. Saudi Med J. 2015;36:549-553 doi: 10.15537/smj.2015.5.11251.
21. Jernberg T, Attebring MF, Hambraeus K, Ivert T, James S, Jeppsson A, Lagerqvist B, Lindahl B, Stenestrand U, Wallentin L. The Swedish web-system for enhancement and development of evidence-based care in heart disease evaluated according to recommended therapies (SWEDEHEART). Heart. 2010;96:1617-1621 doi: 10.1136/hrt.2010.198804.
22. Swedish National Board of Health and Welfare. . Swedish National Patient Register. http://www.socialstyrelsen.se/re...- ouverture dans une nouvelle fenêtre. Accessed June 23, 2016
23. Pinto Slottow TL, Waksman R. Overview of the 2006 Food and Drug Administration Circulatory System Devices Panel meeting on drug-eluting stent thrombosis. Catheter Cardiovasc Interv. 2007;69:1064-1074 doi: 10.1002/ccd.21179
24. Johansson LA, Westerling R. Comparing Swedish hospital discharge records with death certificates: implications for mortality statistics. Int J Epidemiol. 2000;29:495-502 doi: 10.1093/ije/29.3.495.
25. Steinvil A, Zhang YJ, Lee SY, Pang S, Waksman R, Chen SL, Garcia-Garcia HM. Intravascular ultrasound-guided drug-eluting stent implantation: an updated meta-analysis of randomized control trials and observational studies. Int J Cardiol. 2016;216:133-139 doi: 10.1016/j.ijcard.2016.04.154.
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Language: | English.
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Document Type: | Original Articles.
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Journal Subset: | Clinical Medicine.
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ISSN: | 1941-7640
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NLM Journal Code: | 101499602
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DOI Number: | https://dx.doi.org/10.1161/CIRCI...- ouverture dans une nouvelle fenêtre
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