Clinical Benefit of Intravascular Imaging Compared with Conventional Angiography in Left Main Coronary Artery Intervention
- Authors
- Kwon, Woochan; Lee, Joo Myung; Yun, Kyeong Ho; Choi, Ki Hong; Lee, Seung-Jae; Lee, Jong-Young; Lee, Sang Yeub; Kim, Sang Min; Cho, Jae Young; Kim, Chan Joon; Ahn, Hyo-Suk; Nam, Chang-Wook; Yoon, Hyuck-Jun; Park, Yong Hwan; Lee, Wang Soo; Jeong, Jin-Ok; Song, Pil Sang; Doh, Joon-Hyung; Jo, Sang-Ho; Yoon, Chang-Hwan; Kang, Min Gyu; Koh, Jin-Sin; Lee, Kwan Yong; Lim, Young-Hyo; Cho, Yun-Hyeong; Cho, Jin-Man; Jang, Woo Jin; Chun, Kook-Jin; Hong, David; Park, Taek Kyu; Yang, Jeong Hoon; Choi, Seung-Hyuk; Gwon, Hyeon-Cheol; Hahn, Joo-Yong; Song, Young Bin
- Issue Date
- Dec-2023
- Publisher
- Lippincott Williams and Wilkins
- Keywords
- angiography; coronary artery; patients; percutaneous coronary intervention; prognosis
- Citation
- Circulation: Cardiovascular Interventions, v.16, no.12, pp E013359
- Indexed
- SCIE
SCOPUS
- Journal Title
- Circulation: Cardiovascular Interventions
- Volume
- 16
- Number
- 12
- Start Page
- E013359
- URI
- https://scholarworks.gnu.ac.kr/handle/sw.gnu/69019
- DOI
- 10.1161/CIRCINTERVENTIONS.123.013359
- ISSN
- 1941-7640
1941-7632
- Abstract
- BACKGROUND: The RENOVATE-COMPLEX-PCI (Randomized Controlled Trial of Intravascular Imaging Guidance Versus Angiography-Guidance on Clinical Outcomes After Complex Percutaneous Coronary Intervention) demonstrated that intravascular imaging-guided percutaneous coronary intervention (PCI) improved clinical outcome compared with angiography-guided PCI for patients with complex coronary artery lesions. This study aims to assess whether the prognostic benefit of intravascular imaging-guided procedural optimization persists in patients undergoing PCI for left main coronary artery disease. METHODS: Of 1639 patients enrolled in the RENOVATE-COMPLEX-PCI, 192 patients with left main coronary artery disease were selected for the current prespecified substudy. Selected patients were randomly assigned to either the intravascular imaging-guided PCI group (n=138) or the angiography-guided PCI group (n=54). The primary end point was target vessel failure defined as a composite of cardiac death, target vessel-related myocardial infarction, or clinically driven target vessel revascularization. RESULTS: At a median follow-up of 2.1 years (interquartile range 1.1 to 3.0 years), intravascular imaging-guided PCI was associated with lower incidence of primary end point compared with angiography-guided PCI (6.8% versus 25.1%; hazard ratio, 0.31 [95% CI, 0.13-0.76]; P=0.010). This significant reduction in primary end point was mainly driven by a lower risk of cardiac death or spontaneous target vessel-related myocardial infarction (1.6% versus 12.7%; hazard ratio, 0.16 [95% CI, 0.03-0.82]; P=0.028). Intravascular imaging-guided PCI was independently associated with a lower risk of primary end point, even after adjusting for various clinical factors (hazard ratio, 0.29 [95% CI, 0.12-0.72]; P=0.007). CONCLUSIONS: Intravascular imaging-guided PCI showed clinical benefit over angiography-guided PCI for left main coronary artery disease in reducing the risk of cardiac death, target vessel-related myocardial infarction, or target vessel revascularization. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT03381872. © 2023 Lippincott Williams and Wilkins. All rights reserved.
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