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Usefulness of minimum stent cross sectional area as a predictor of angiographic restenosis after primary percutaneous coronary intervention in acute myocardial infarction (from the HORIZONS-AMI Trial IVUS substudy)

Authors
Choi, SY; Maehara, A; Cristea, E; Witzenbichler, B; Guagliumi, G; Brodie, B; Kellett, MA Jr; Dressler, O; Lansky, AJ; Parise, H; Mehran, R; Mintz, GS; Stone, GW
Citation
The American journal of cardiology, 109(4):455-460, 2012
Journal Title
The American journal of cardiology
ISSN
0002-91491879-1913
Abstract
HORIZONS-AMI was a prospective dual-arm randomized trial of different antithrombotic regimens and stent types in patients with ST-segment elevation myocardial infarction. A formal intravascular ultrasound (IVUS) substudy enrolled 464 patients with baseline and 13-month follow-up at 36 centers. Of them, 318 patients with 355 lesions were evaluated for this study. Angiographic restenosis occurred in 45 of 355 lesions (12.7%). Bare-metal stent use (45.5% vs 21.2%, p <0.001) and diabetes mellitus (29.5% vs 10.9%, p <0.001) were more prevalent in patients with versus without restenosis. Postprocedure IVUS minimum lumen area (5.6 mm(2), 5.0 to 6.1, vs 6.7 mm(2), 6.5 to 6.9, p <0.001), minimum stent area (5.7 mm(2), 5.1 to 6.3, vs 6.9 mm(2), 6.6 to 7.1, p <0.001), and reference average lumen area (7.7 mm(2), 6.8 to 8.6, vs 9.7 mm(2), 9.3 to 10.1, p <0.001) were smaller in restenotic versus nonrestenotic lesions. By multivariable analysis, minimum stent area was an independent predictor of angiographic restenosis (odds ratio 0.75, 95% confidence interval 0.61 to 0.93, p = 0.009) in addition to diabetes, bare-metal stent use, and longer stent length. Attenuated plaque behind the stent struts had a trend to predict less binary restenosis (p = 0.07). In conclusion, a smaller IVUS minimum stent area was an independent predictor of angiographic restenosis after primary percutaneous intervention in patients with ST-segment elevation myocardial infarction, similar to patients with stable coronary artery disease.
MeSH terms
*Angioplasty, Balloon, CoronaryCoronary AngiographyCoronary Restenosis/*radiography/*ultrasonographyCoronary Vessels/ultrasonographyDiabetes Mellitus/epidemiologyFemaleHumansMaleMiddle AgedMultivariate AnalysisMyocardial Infarction/*therapyProspective StudiesProsthesis Design*StentsUltrasonography, Interventional
DOI
10.1016/j.amjcard.2011.10.005
PMID
22118823
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Cardiology
AJOU Authors
최, 소연
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