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Long-term outcomes of intravascular ultrasound-guided implantation of bare metal stents versus drug-eluting stents in primary percutaneous coronary intervention
The Korean Journal of Internal Medicine ; : 66-75, 2014.
Artigo em Inglês | WPRIM | ID: wpr-224081
ABSTRACT
BACKGROUND/

AIMS:

While drug-eluting stents (DESs) have shown favorable outcomes in ST-segment elevation myocardial infarction (STEMI) compared to bare metal stents (BMSs), there are concerns about the risk of stent thrombosis (ST) with DESs. Because intravascular ultrasound (IVUS) guidance may help optimize stent placement and improve outcomes in percutaneous coronary intervention (PCI) patients, we evaluated the impact of IVUS-guided BMS versus DES implantation on long-term outcomes in primary PCI.

METHODS:

In all, 239 STEMI patients received DES (n = 172) or BMS (n = 67) under IVUS guidance in primary PCI. The 3-year incidence of major adverse cardiac events (MACEs) including death, myocardial infarction (MI), target vessel revascularization (TVR), and ST was evaluated.

RESULTS:

There was no difference in all cause mortality or MI. However, the incidence of TVR was 23.9% with BMS versus 9.3% with DES (p = 0.005). Thus, the number of MACEs was significantly lower with DES (11.0% vs. 29.9%; p = 0.001). The incidence of definite or probable ST was not different (1.5% vs. 2.3%; p = 1.0). IVUS-guided DES implantation (hazard ratio [HR], 0.25; 95% confidence interval [CI], 0.08 to 0.78; p = 0.017), stent length (HR, 1.03; 95% CI, 1.00 to 1.06; p = 0.046), and multivessel disease (HR, 3.01; 95% CI, 1.11 to 8.15; p = 0.030) were independent predictors of MACE.

CONCLUSIONS:

In patients treated with primary PCI under IVUS guidance, the use of DES reduced the incidence of 3-year TVR versus BMS. However, all cause mortality and MI were similar between the groups. The incidence of ST was low in both groups.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Reoperação / Estudos Retrospectivos / Seguimentos / Resultado do Tratamento / Ultrassonografia de Intervenção / Stents Farmacológicos / República da Coreia / Intervenção Coronária Percutânea / Infarto do Miocárdio Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: Ásia Idioma: Inglês Revista: The Korean Journal of Internal Medicine Ano de publicação: 2014 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Reoperação / Estudos Retrospectivos / Seguimentos / Resultado do Tratamento / Ultrassonografia de Intervenção / Stents Farmacológicos / República da Coreia / Intervenção Coronária Percutânea / Infarto do Miocárdio Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Idoso / Feminino / Humanos / Masculino País/Região como assunto: Ásia Idioma: Inglês Revista: The Korean Journal of Internal Medicine Ano de publicação: 2014 Tipo de documento: Artigo