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Intravascular Imaging-Guided or Angiography-Guided Complex PCI
- Title
- Intravascular Imaging-Guided or Angiography-Guided Complex PCI
- Authors
- Lee, Joo Myung; Choi, Ki Hong; Song, Young Bin; Lee, Jong-Young; Lee, Seung-Jae; Lee, Sang Yeub; Kim, Sang Min; Yun, Kyeong Ho; 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
- Ewha Authors
- 장우진
- SCOPUS Author ID
- 장우진
- Journal Title
- NEW ENGLAND JOURNAL OF MEDICINE
- ISSN
- 0028-4793
1533-4406
- Citation
- NEW ENGLAND JOURNAL OF MEDICINE
- Publisher
- MASSACHUSETTS MEDICAL SOC
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
Early Access
- Abstract
- BACKGROUNDData regarding clinical outcomes after intravascular imaging-guided percutaneous coronary intervention (PCI) for complex coronary-artery lesions, as compared with outcomes after angiography-guided PCI, are limited. METHODSIn this prospective, multicenter, open-label trial in South Korea, we randomly assigned patients with complex coronary-artery lesions in a 2:1 ratio to undergo either intravascular imaging-guided PCI or angiography-guided PCI. In the intra-vascular imaging group, the choice between intravascular ultrasonography and optical coherence tomography was at the operators' discretion. The primary end point was a composite of death from cardiac causes, target-vessel-related myocardial infarction, or clinically driven target-vessel revascularization. Safety was also assessed. RESULTSA total of 1639 patients underwent randomization, with 1092 assigned to undergo intravascular imaging-guided PCI and 547 assigned to undergo angiography-guided PCI. At a median follow-up of 2.1 years (interquartile range, 1.4 to 3.0), a primary end-point event had occurred in 76 patients (cumulative incidence, 7.7%) in the intravascular imaging group and in 60 patients (cumulative incidence, 12.3%) in the angiography group (hazard ratio, 0.64; 95% confidence interval, 0.45 to 0.89; P = 0.008). Death from cardiac causes occurred in 16 patients (cumulative incidence, 1.7%) in the intravascular imaging group and in 17 patients (cumulative incidence, 3.8%) in the angiography group; target-vessel-related myocardial in-farction occurred in 38 (cumulative incidence, 3.7%) and 30 (cumulative incidence, 5.6%), respectively; and clinically driven target-vessel revascularization in 32 (cumulative incidence, 3.4%) and 25 (cumulative incidence, 5.5%), respectively. There were no apparent between-group differences in the incidence of procedure-related safety events. CONCLUSIONSAmong patients with complex coronary-artery lesions, intravascular imaging- guided PCI led to a lower risk of a composite of death from cardiac causes, target-vessel-related myocardial infarction, or clinically driven target-vessel revascularization than angiography-guided PCI. (Supported by Abbott Vascular and Boston Scientific; RENOVATE-COMPLEX-PCI ClinicalTrials.gov number, NCT03381872).
- DOI
- 10.1056/NEJMoa2216607
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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