Clinical Benefit of Intravascular Imaging Compared With Conventional Angiography in Left Main Coronary Artery Intervention-Reference-Cited by-同舟云学术

Clinical Benefit of Intravascular Imaging Compared With Conventional Angiography in Left Main Coronary Artery Intervention

Published:2023-12 Issue:12 Volume:16 Page:
ISSN:1941-7640
Container-title:Circulation: Cardiovascular Interventions
language:en
Short-container-title:Circ: Cardiovascular Interventions

Author:

Kwon Woochan¹^ORCID,Lee Joo Myung¹^ORCID,Yun Kyeong Ho²^ORCID,Choi Ki Hong¹^ORCID,Lee Seung-Jae³^ORCID,Lee Jong-Young³,Lee Sang Yeub⁴⁵^ORCID,Kim Sang Min⁴^ORCID,Cho Jae Young²^ORCID,Kim Chan Joon⁶,Ahn Hyo-Suk⁶^ORCID,Nam Chang-Wook⁷^ORCID,Yoon Hyuck-Jun⁷^ORCID,Park Yong Hwan⁸,Lee Wang Soo⁹^ORCID,Jeong Jin-Ok¹⁰^ORCID,Song Pil Sang¹⁰^ORCID,Doh Joon-Hyung¹¹^ORCID,Jo Sang-Ho¹²^ORCID,Yoon Chang-Hwan¹³^ORCID,Kang Min Gyu¹⁴^ORCID,Koh Jin-Sin¹⁴^ORCID,Lee Kwan Yong¹⁵,Lim Young-Hyo¹⁶^ORCID,Cho Yun-Hyeong¹⁷^ORCID,Cho Jin-Man¹⁸,Jang Woo Jin¹⁹^ORCID,Chun Kook-Jin²⁰^ORCID,Hong David¹^ORCID,Park Taek Kyu¹^ORCID,Yang Jeong Hoon¹^ORCID,Choi Seung-Hyuk¹^ORCID,Gwon Hyeon-Cheol¹^ORCID,Hahn Joo-Yong¹^ORCID,Song Young Bin¹^ORCID,

Affiliation:

1. Samsung Medical Center (W.K., J.M.L., K.H.C., D.H., T.K.P., J.H.Y., S.-H.C., H.-C.G., J.-Y.H., Y.B.S.), Sungkyunkwan University School of Medicine, Seoul, Korea.

2. Wonkwang University Hospital, Iksan, Korea (K.H.Y., J.Y.C.).

3. Kangbuk Samsung Hospital (S.-J.L., J.-Y.L.), Sungkyunkwan University School of Medicine, Seoul, Korea.

4. Chungbuk National University Hospital, Chungbuk National University College of Medicine, Cheongju, Korea (S.Y.L., S.M.K.).

5. Chung-Ang University College of Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea (S.Y.L.).

6. The Catholic University of Korea, Uijeongbu St. Mary’s Hospital, Seoul (C.J.K., H.-S.A.).

7. Keimyung University Dongsan Hospital, Daegu, Korea (C.-W.N., H.-J.Y.).

8. Samsung Changwon Hospital (Y.H.P.), Sungkyunkwan University School of Medicine, Seoul, Korea.

9. Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea (W.S.L.).

10. Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea (J.-O.K., P.S.S.).

11. Inje University Ilsan-Paik hospital, Goyang, Korea (J.-H.D.).

12. Cardiovascular Center, Hallym University Sacred Heart Hospital, Anyang, Korea (S.-H.J.).

13. Seoul National University Bundang Hospital, Seongnam, Korea (C.-H.Y.).

14. Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea (M.G.K., J.-S.K.).

15. The Catholic University of Korea, Incheon St Mary’s Hospital, Seoul (K.Y.L.).

16. Hanyang University Seoul Hospital, College of Medicine, Hanyang University, Seoul, Korea (Y.-H.L.).

17. Hanyang University Myongji Hospital, Goyang, Korea (Y.-H.C.).

18. Kyung Hee University Hospital at Gangdong, Seoul, Korea (J.-M.C.).

19. Ewha Womans University College of Medicine, Seoul, Korea (W.J.J.).

20. Pusan National University Yangsan Hospital, Yangsan, Korea (K.-J.C.).

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.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Cardiology and Cardiovascular Medicine

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