Role of Intravascular Ultrasound in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Title
Role of Intravascular Ultrasound in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention
Author(s)
김영조Khurshid Ahmed[Khurshid Ahmed]정명호[정명호]Rabin Chakraborty[Rabin Chakraborty]안영근[안영근]심두선[심두선]박근호[박근호]홍영준[홍영준]김주한[김주한]조경훈[조경훈]김민철[김민철]다이스케 하치노헤[다이스케 하치노헤]황승환[황승환]이민구[이민구]조명찬[조명찬]김청진[김청진]박종천[박종천]강정채[강정채]
Keywords
ELUTING STENT IMPLANTATION; RESTENOSIS; GUIDANCE; THROMBOSIS; MULTICENTER; PREDICTORS; IMPACT; PLAQUE; UNDEREXPANSION; ANGIOGRAPHY
Issue Date
201107
Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Citation
AMERICAN JOURNAL OF CARDIOLOGY, v.108, no.1, pp.8 - 14
Abstract
Stent thrombosis and restenosis remain drawbacks of drug-eluting stents in patients with acute myocardial infarction (AMI). Intravascular ultrasound (IVUS) guidance for stent deployment helps optimize its results in stable patients. The aim of this study was to examine the utility of routine IVUS guidance in patients with AMI undergoing percutaneous coronary intervention (PCI). Employing data from Korea Acute Myocardial Infarction Registry (KAMIR), we analyzed 14,329 patients with AM! from April 2006 through September 2010. Patients with cardiogenic shock and rescue PCI after thrombolysis were excluded. Clinical outcomes of 2,127 patients who underwent IVUS-guided PCI were compared to those of 8,235 patients who did not. Mean age was 63.6 +/- 13.5 years and 72.3% were men. Patients undergoing IVUS-guided PCI were younger, more often men, more hyperlipemic, and had increased body mass index and left ventricular ejection fraction. Number of treated vessels and stents used, stent length, and stent diameter were increased in the IVUS-guided group. Multivessel involvement was less frequent and American College of Cardiology/American Heart Association type C lesion was more frequent in the IVUS-guided group. Drug-eluting stents were more frequently used compared to bare-metal stents in the IVUS group. There was no significant relation of stent thrombosis between the 2 groups. Twelve-month all-cause death was lower in the IVUS group. After multivariate analysis and propensity score adjustment, IVUS guidance was not an independent predictor for 12-month all-cause death (hazard ratio 0.212, 0.026 to 1.73, p = 0.148). In conclusion, this study does not support routine use of IVUS guidance for stent deployment in patients who present with AMI and undergo PCI. (C) 2011 Elsevier Inc. All rights reserved. (Am J Cardiol 2011;108:8-14)
URI
http://hdl.handle.net/YU.REPOSITORY/24875http://dx.doi.org/10.1016/j.amjcard.2011.02.339
ISSN
0002-9149
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의과대학 > 내과학교실 > Articles
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