Details

Autor(en) / Beteiligte

• Bruno, Francesco
• de Filippo, Ovidio
• Sardone, Andrea
• Capranzano, Piera
• Conrotto, Federico
• Sheiban, Imad
• Giacobbe, Federico
• Laudani, Claudio
• Burzotta, Francesco
• Saia, Francesco
• Escaned, Javier
• Raposeiras Roubin, Sergio
• Mancone, Massimo
• Templin, Christian
• Candreva, Alessandro
• Trabattoni, Daniela
• Wanha, Wojciech
• Stefanini, Giulio
• Chieffo, Alaide
• Cortese, Bernardo
• Casella, Gianni
• Wojakowski, Wojciech
• Colombo, Francesco
• De Ferrari, Gaetano Maria
• Boccuzzi, Giacomo
• D'Ascenzo, Fabrizio
• Iannaccone, Mario

Titel

Long-term impact of intravascular ultrasound-guidance for percutaneous coronary intervention on unprotected left main. The IMPACTUS-LM, an observational, multicentric study

Ist Teil von

• International journal of cardiology, 2024-04, Vol.401, p.131861-131861, Article 131861

Ort / Verlag

Netherlands: Elsevier B.V

Erscheinungsjahr

2024

Quelle

MEDLINE

Beschreibungen/Notizen

• The potential benefit on long term outcomes of Percutaneous Coronary Intervention (PCI) on Unprotected Left Main (ULM) driven by IntraVascular UltraSound (IVUS) remains to be defined. IMPACTUS LM-PCI is an observational, multicenter study that enrolled consecutive patients with ULM disease undergoing coronary angioplasty in 13 European high-volume centers from January 2002 to December 2015. Major Adverse Cardiovascular Events (MACEs) a composite of cardiovascular (CV) death, target vessel revascularization (TVR) and myocardial infarction (MI) were the primary endpoints, while its single components along with all cause death the secondary ones. 627 patients with ULM disease were enrolled, 213 patients (34%) underwent IVUS-guided PCI while 414 (66%) angioguided PCI. Patients in the two cohorts had similar prevalence of risk factors except for active smoking and clinical presentation. During a median follow-up of 7.5 years, 47 (22%) patients in the IVUS group and 211 (51%) in the angio-guided group underwent the primary endpoint (HR 0.42; 95% CI [0.31–0.58] p < 0.001). After multivariate adjustment, IVUS was significantly associated with a reduced incidence of the primary endpoint (adj HR 0.39; 95% CI [0.23–0.64], p < 0.001), mainly driven by a reduction of TVR (ad HR 0.30, 95% CI [0.15–0.62], p = 0.001) and of all-cause death (adj HR 0.47, 95% CI [0.28–0.82], p = 0.008). IVUS use, age, diabetes, side branch stenosis, DES and creatinine at admission were independent predictors of MACE. In patients undergoing ULM PCI, the use of IVUS was associated with a reduced risk at long-term follow-up of MACE, all-cause death and subsequent revascularization. •IVUS is superior to angio-guided PCI in terms of MACE, however data are mainly limited to short or mid-term follow-up.•IVUS for left main PCI was associated with lower MACE, all-cause death and TVR at a 15-year follow-up.•IVUS use, age, diabetes, side branch stenosis, DES and creatinine at admission were independent predictors of MACE in LM PCI.