Intravascular Ultrasound Predictors of Major Adverse Cardiovascular Events After Implantation of Everolimus-eluting Stents for Long Coronary Lesions

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• 作者：Seung-Yul Lee^a ; Dong-Ho Shin^b ; ^c ; Jung-Sun Kim^b ; ^c ; Byeong-Keuk Kim^b ; ^c ; Young-Guk Ko^b ; ^c ; Donghoon Choi^b ; ^c ; Yangsoo Jang^b ; ^c ; ^d ; Myeong-Ki Hong^b ; ^c ; ^d ; ^{mkhong61@yuhs.ac}
• 关键词：Coronary artery disease ; Drug-eluting stent ; Intravascular ultrasound
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2017
• 出版时间：February 2017
• 年：2017
• 卷：70
• 期：2
• 页码：88-95
• 全文大小：676 K
• 卷排序：70

文摘

There are limited data on the usefulness of intravascular ultrasound (IVUS) for long coronary lesions treated with second-generation drug-eluting stents. We evaluated IVUS predictors of major adverse cardiovascular events (MACE) 12 months after implantation of everolimus-eluting stents for long coronary lesions.MethodsA total of 804 patients who underwent both postintervention IVUS examination and long everolimus-eluting stent (≥ 28 mm in length) implantation were included from 2 randomized trials. MACE was defined as a composite of cardiac death, myocardial infarction, and target-lesion revascularization.ResultsMACE occurred in 24 patients (3.0%) over 12 months. On multivariable Cox regression analysis, independent IVUS predictors of MACE included the postintervention minimum lumen area (MLA) at the target lesion (HR = 0.623; 95%CI, 0.433-0.895; P = .010) and the ratio of MLA/distal reference segment lumen area (HR = 0.744; 95%CI, 0.572-0.969; P = .028). The MLA and MLA-to-distal reference segment lumen area ratio that best predicted patients with MACE from those without these events were 5.0 mm2 and 1.0, respectively. Patients with MLA < 5.0 mm2 or a distal reference segment lumen area had a higher risk of MACE (HR = 6.231; 95%CI, 1.859-20.891; P = .003) than those without MACE.ConclusionsPatients with a postintervention IVUS-measured MLA of < 5.0 mm2 or a distal reference segment lumen area were at risk for MACE after long everolimus-eluting stent implantation.