- 著者
- Ji Woong Roh SungA Bae Thomas W. Johnson Seok-Jae Heo Yongcheol Kim Deok-Kyu Cho Jung-Sun Kim Byeong-Keuk Kim Donghoon Choi Myeong-Ki Hong Yangsoo Jang Myung Ho Jeong on behalf of the KAMIR-NIH Investigators
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- pp.CJ-23-0189, (Released:2023-05-30)
- 参考文献数
- 21
- 被引用文献数
- 2
Background: In the setting of acute myocardial infarction (AMI), there are no data regarding the benefits of intravascular ultrasound (IVUS) for chronic kidney disease (CKD) patients.Methods and Results: This study used data from the Korea Acute Myocardial Infarction Registry, a large, multicenter prospective cohort. We evaluated 1,759 patients with AMI and CKD, defined as estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, and patients were classified into 2 groups: with and without IVUS. The primary outcome was target lesion failure (TLF) at 3 years. The hazard ratio (HR) of TLF according to eGFR was also analyzed. A total of 1,759 patients with AMI and CKD who underwent IVUS-guided PCI (19.2%) had a significantly lower risk of TLF at 3 years (8.9% vs. 15.3%; HR 0.55; 95% confidence interval [CI]: 0.38 to 0.81; P=0.002) than those who underwent angiography-guided PCI, regardless of their eGFR and the presence of end-stage renal disease (ESRD). The results were consistent after confounder adjustment and inversed probability weighting.Conclusions: In patients with CKD and AMI who underwent PCI with 2nd-generation DES implantation, the use of IVUS guidance was associated with a significant reduction in 3-year TLF and showed consistently favorable outcomes regardless of eGFR and ESRD.
- 著者
- Albert Youngwoo Jang Minsu Kim Pyung Chun Oh Soon Yong Suh Kyounghoon Lee Woong Chol Kang Ki Hong Choi Young Bin Song Hyeon-Cheol Gwon Hyo-Soo Kim Woo Jung Chun Seung-Ho Hur Seung-Woon Rha In-Ho Chae Jin-Ok Jeong Jung Ho Heo Junghan Yoon Soon Jun Hong Jong-Seon Park Myeong-Ki Hong Joon-Hyung Doh Kwang Soo Cha Doo-Il Kim Sang Yeub Lee Kiyuk Chang Byung-Hee Hwang So-Yeon Choi Myung Ho Jeong Chang-Wook Nam Bon-Kwon Koo Seung Hwan Han
- 出版者
- The Japanese Circulation Society
- 雑誌
- Circulation Journal (ISSN:13469843)
- 巻号頁・発行日
- vol.86, no.9, pp.1365-1375, 2022-08-25 (Released:2022-08-25)
- 参考文献数
- 17
- 被引用文献数
- 1 1
Background: Differences in the impact of the 1- or 2-stent strategy in similar coronary bifurcation lesion conditions are not well understood. This study investigated the clinical outcomes and its predictors between 1 or 2 stents in propensity score-matched (PSM) complex bifurcation lesions.Methods and Results: We analyzed the data of patients with bifurcation lesions, obtained from a multicenter registry of 2,648 patients (median follow up, 53 months). The patients were treated by second generation drug-eluting stents (DESs). The primary outcome was target lesion failure (TLF), composite of cardiac death, target vessel myocardial infarction (TVMI), and ischemia-driven target lesion revascularization (TLR). PSM was performed to balance baseline clinical and angiographic discrepancies between 1 and 2 stents. After PSM (N=333 from each group), the 2-stent group had more TLRs (hazard ratio [HR] 3.14, 95% confidence interval [CI] 1.42–6.97, P=0.005) and fewer hard endpoints (composite of cardiac death and TVMI; HR 0.44, 95% CI 0.19–1.01, P=0.054), which resulted in a similar TLF rate (HR 1.40, 95% CI 0.83–2.37, P=0.209) compared to the 1-stent group. Compared with 1-stent, the 2-stent technique was more frequently associated with less TLF in the presence of main vessel (pinteraction=0.008) and side branch calcification (pinteraction=0.010).Conclusions: The 2-stent strategy should be considered to reduce hard clinical endpoints in complex bifurcation lesions, particularly those with calcifications.