Intravascular Ultrasound Guidance Is Associated With Better Outcome in Patients Undergoing Unprotected Left Main Coronary Artery Stenting Compared With Angiography Guidance Alone

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Intravascular Ultrasound Guidance Is Associated With Better Outcome in Patients Undergoing Unprotected Left Main Coronary Artery Stenting Compared With Angiography Guidance Alone

Andell, Pontus (författare): Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.

Karlsson, Sofia (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.

Mohammad, Moman A. (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.

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Götberg, Matthias (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.

James, Stefan, 1964- (författare): Uppsala universitet,Uppsala University,Kardiologi

Jensen, Jens (författare): Karolinska Institute,Karolinska Institutet,Karolinska Inst, Soder Sjukhuset, Dept Clin Sci & Educ, Stockholm, Sweden.;Capio St Gorans Sjukhus, Unit Med, Stockholm, Sweden.

Fröbert, Ole, 1964- (författare): Örebro University,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Cardiology, Örebro University Hospital, Örebro, Sweden,Orebro Univ, Fac Hlth, Dept Cardiol, Orebro, Sweden.

Angeras, Oskar (författare): Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden; University and Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Acad, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.

Nilsson, Johan (författare): Umeå University,Umea Univ Hosp, Heart Ctr, Dept Cardiol, Umea, Sweden.

Omerovic, Elmir (författare): Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, Gothenburg, Sweden; University and Department of Cardiology, Sahlgrenska University Hospital, Gothenburg, Sweden,Sahlgrens Acad, Inst Med, Dept Mol & Clin Med, Gothenburg, Sweden.;Univ Gothenburg, Gothenburg, Sweden.;Sahlgrens Univ Hosp, Dept Cardiol, Gothenburg, Sweden.

Lagerqvist, Bo, 1952- (författare): Uppsala universitet,Uppsala University,Kardiologi

Persson, Jonas (författare): Division of Cardiovascular Medicine, Department of Clinical Sciences, Danderyd Hospital, Stockholm, Sweden,Danderyd Hosp, Karolinska Inst, Dept Clin Sci, Div Cardiovasc Med, Stockholm, Sweden.

Koul, Sasha (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.

Erlinge, David (författare): Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital,Lund Univ, Skane Univ Hosp, Dept Cardiol, Clin Sci, Lund, Sweden.

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Lippincott Williams & Wilkins, 2017
2017
Engelska.
Ingår i: Circulation. Cardiovascular Interventions. - : Lippincott Williams & Wilkins. - 1941-7640 .- 1941-7632. ; 10:5

Relaterad länk:: http://dx.doi.org/10...; visa fler...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; https://lup.lub.lu.s...; https://urn.kb.se/re...; visa färre...

Tidskriftsartikel (refereegranskat)

Abstract Ämnesord

Stäng

Background: Small observational studies have indicated better outcome with intravascular ultrasound (IVUS) guidance when performing unprotected left main coronary artery (LMCA) percutaneous coronary intervention (PCI), but the overall picture remains inconclusive and warrants further investigation. We studied the impact of IVUS guidance on outcome in patients undergoing unprotected LMCA PCI in a Swedish nationwide observational study.Methods and Results: Patients who underwent unprotected LMCA PCI between 2005 and 2014 because of stable coronary artery disease or acute coronary syndrome were included from the nationwide SCAAR (Swedish Coronary Angiography and Angioplasty Registry). Of 2468 patients, IVUS guidance was used in 621 (25.2%). The IVUS group was younger (median age, 70 versus 75 years) and had fewer comorbidities but more complex lesions. IVUS was associated with larger stent diameters (median, 4 mm versus 3.5 mm). After adjusting for potential confounders, IVUS was associated with significantly lower occurrence of the primary composite end point of all-cause mortality, restenosis, or definite stent thrombosis (hazard ratio, 0.65; 95% confidence interval, 0.50-0.84) and all-cause mortality alone (hazard ratio, 0.62; 95% confidence interval, 0.47-0.82). In 340 propensity score-matched pairs, IVUS was also associated with significantly lower occurrence of the primary end point (hazard ratio, 0.54; 95% confidence interval, 0.37-0.80).Conclusions: IVUS was associated with an independent and significant outcome benefit when performing unprotected LMCA PCI. Potential mediators of this benefit include larger and more appropriately sized stents, perhaps translating into lower risk of subsequent stent thrombosis. Although residual confounding cannot be ruled out, our findings indicate a possible hazard when performing unprotected LMCA PCI without IVUS guidance.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

acute coronary syndrome
angioplasty
comorbidity
percutaneous coronary intervention
thrombosis
Cardiology
Kardiologi
acute coronary syndrome
angioplasty
comorbidity
percutaneous coronary intervention
thrombosis

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Av författaren/redakt...: Andell, Pontus; Karlsson, Sofia; Mohammad, Moman ...; Götberg, Matthia ...; James, Stefan, 1 ...; Jensen, Jens; visa fler...; Fröbert, Ole, 19 ...; Angeras, Oskar; Nilsson, Johan; Omerovic, Elmir; Lagerqvist, Bo, ...; Persson, Jonas; Koul, Sasha; Erlinge, David; visa färre...

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Kardiologi

Artiklar i publikationen: Circulation. Car ...

Av lärosätet: Örebro universitet; Karolinska Institutet; Lunds universitet; Uppsala universitet

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