Clinical Impact of Intravascular Ultrasound-Guided Chronic Total Occlusion Intervention With Zotarolimus-Eluting Versus Biolimus-Eluting Stent Implantation Randomized Study
- Authors
- Kim, Byeong-Keuk; Shin, Dong-Ho; Hong, Myeong-Ki; Park, Hun Sik; Rha, Seung-Woon; Mintz, Gary S.; Kim, Jung-Sun; Kim, Je Sang; Lee, Seung-Jin; Kim, Hee-Yeol; Hong, Bum-Kee; Kang, Woong-Chol; Choi, Jin-Ho; Jang, Yangsoo
- Issue Date
- 7월-2015
- Publisher
- LIPPINCOTT WILLIAMS & WILKINS
- Keywords
- coronary occlusion; drug-eluting stents; ultrasonography, interventional
- Citation
- CIRCULATION-CARDIOVASCULAR INTERVENTIONS, v.8, no.7
- Indexed
- SCIE
SCOPUS
- Journal Title
- CIRCULATION-CARDIOVASCULAR INTERVENTIONS
- Volume
- 8
- Number
- 7
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/93203
- DOI
- 10.1161/CIRCINTERVENTIONS.115.002592
- ISSN
- 1941-7640
- Abstract
- Background-There have been no randomized studies comparing intravascular ultrasound (IVUS)-guided versus conventional angiography-guided chronic total occlusion (CTO) intervention using new-generation drug-eluting stent Therefore, we conducted a prospective, randomized, multicenter trial designed to test the hypothesis that IVUS-guided CTO intervention is superior to angiography-guided intervention. Methods and Results-After successful guidewire crossing, 402 patients with CTOs were randomized to the IVUS-guided group (n=201) or the angiography-guided group (n=201) and secondarily randomized to Resolute zotarolimus-eluting stents or Nobori biolimus-eluting stents. The primary and secondary end points were cardiac death and a major adverse cardiac event defined as the composite of cardiac death, myocardial infarction, or target-vessel revascularization, respectively. After 12-month follow-up, the rate of cardiac death was not significantly different between the IVUS-guided group (0%) and the angiography-guided group (1.0%; P by log-rank test=0.16). However, major adverse cardiac event rates were significantly lower in the IVUS-guided group than that in the angiography-guided group (2.6% versus 7.1%; P=0.035; hazard ratio, 0.35; 95% confidence interval, 0.13-0.97). Occurrence of the composite of cardiac death or myocardial infarction was significantly lower in the IVUS-guided group (0%) than in the angiography-guided group (2.0%; P=0.045). The rates of target-vessel revascularization were not significantly different between the 2 groups. In the comparison between Resolute zotarolimus-eluting stent and Nobori biolimus-eluting stent, major adverse cardiac event rates were not significantly different (4.0% versus 5.7%; P=0.45). Conclusions-Although IVUS-guided CTO intervention did not significantly reduce cardiac mortality, this randomized study demonstrated that IVUS-guided CTO intervention might improve 12-month major adverse cardiac event rate after new-generation drug-eluting stent implantation when compared with conventional angiography-guided CTO intervention.
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Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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