TY - JOUR
T1 - Impact of intravascular ultrasound on the long-term clinical outcomes in the treatment of coronary ostial lesions
AU - Patel, Yogesh
AU - Depta, Jeremiah P.
AU - Patel, Jayendrakumar S.
AU - Masrani, Shriti K.
AU - Novak, Eric
AU - Zajarias, Alan
AU - Kurz, Howard I.
AU - Lasala, John M.
AU - Bach, Richard G.
AU - Singh, Jasvindar
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
PY - 2016/2/1
Y1 - 2016/2/1
N2 - Objectives To evaluate the long-term outcomes of patients with ostial lesions who underwent percutaneous coronary intervention (PCI) with and without the use of intravascular ultrasound (IVUS). Background A higher rate of adverse cardiac events is associated with PCI of ostial lesions as compared with nonostial disease. Methods From 7/2002 to 8/2010, 225 patients with 233 coronary ostial lesions underwent PCI with (n = 82) and without (n = 143) IVUS guidance. Ostial lesions included both native aorto-ostial or major coronary vessel (left anterior descending, left circumflex, and ramus intermedius) lesions. Clinical outcomes [cardiovascular death, myocardial infarction (MI), and target lesion revascularization (TLR)] at a mean follow-up of 4.2 ± 2.5 years were compared between patients undergoing PCI of an ostial lesion with and without use of IVUS using univariate and propensity score adjusted analyses. Results Aorto-ostial lesions (n = 109) comprised 47% of lesions, whereas the remaining lesions (53%) involved major coronary vessels. After propensity score adjustment, IVUS use was associated with lower rates of the composite of cardiovascular death, MI, or TLR (HR 0.54, 95% CI 0.29-0.99; P = 0.04), composite MI or TLR (HR 0.39, 95% CI 0.18-0.83; P = 0.01), and MI (HR 0.31, 95% CI 0.11-0.85; P = 0.02) as compared with no IVUS. The use of IVUS was also associated with a trend towards a lower rate of TLR (HR 0.42, 95% CI 0.17-1.02; P = 0.06). Conclusions PCI of coronary ostial lesions with the use of IVUS was associated with significantly lower rates of adverse cardiac events.
AB - Objectives To evaluate the long-term outcomes of patients with ostial lesions who underwent percutaneous coronary intervention (PCI) with and without the use of intravascular ultrasound (IVUS). Background A higher rate of adverse cardiac events is associated with PCI of ostial lesions as compared with nonostial disease. Methods From 7/2002 to 8/2010, 225 patients with 233 coronary ostial lesions underwent PCI with (n = 82) and without (n = 143) IVUS guidance. Ostial lesions included both native aorto-ostial or major coronary vessel (left anterior descending, left circumflex, and ramus intermedius) lesions. Clinical outcomes [cardiovascular death, myocardial infarction (MI), and target lesion revascularization (TLR)] at a mean follow-up of 4.2 ± 2.5 years were compared between patients undergoing PCI of an ostial lesion with and without use of IVUS using univariate and propensity score adjusted analyses. Results Aorto-ostial lesions (n = 109) comprised 47% of lesions, whereas the remaining lesions (53%) involved major coronary vessels. After propensity score adjustment, IVUS use was associated with lower rates of the composite of cardiovascular death, MI, or TLR (HR 0.54, 95% CI 0.29-0.99; P = 0.04), composite MI or TLR (HR 0.39, 95% CI 0.18-0.83; P = 0.01), and MI (HR 0.31, 95% CI 0.11-0.85; P = 0.02) as compared with no IVUS. The use of IVUS was also associated with a trend towards a lower rate of TLR (HR 0.42, 95% CI 0.17-1.02; P = 0.06). Conclusions PCI of coronary ostial lesions with the use of IVUS was associated with significantly lower rates of adverse cardiac events.
KW - coronary ostial
KW - intravascular ultrasound
KW - percutaneous coronary intervention
UR - http://www.scopus.com/inward/record.url?scp=84959523764&partnerID=8YFLogxK
U2 - 10.1002/ccd.25034
DO - 10.1002/ccd.25034
M3 - Article
C2 - 23728924
AN - SCOPUS:84959523764
SN - 1522-1946
VL - 87
SP - 232
EP - 240
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 2
ER -