Long-term outcomes of intravascular ultrasound-guided drug-eluting stents implantation in patients with acute coronary syndrome: ULTIMATE ACS subgroup
10.3760/cma.j.cn112148-20231008-00239
- VernacularTitle:IVUS指导DES置入在ACS患者中的长期预后评价：ULTIMATE研究ACS亚组分析
- Author:
Xiaofei GAO
1
;
Leng HAN
;
Xuesong QIAN
;
Zhen GE
;
Xiangquan KONG
;
Shu LU
;
Jing KAN
;
Guangfeng ZUO
;
Junjie ZHANG
;
Shaoliang CHEN
Author Information
1. 南京医科大学附属南京医院 南京市第一医院心内科，南京 210006
- Keywords:
Drug-eluting stent;
Coronary angiography;
Intravascular ultrasound;
Acute coronary syndrome
- From:
Chinese Journal of Cardiology
2024;52(2):137-143
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the long-term effects of intravascular ultrasound (IVUS) guidance on patients with acute coronary syndrome (ACS) undergoing drug-eluting stents (DES) implantation.Methods:Data used in this study derived from ULTIMATE trial, which was a prospective, multicenter, randomized study. A total of 1 448 all-comer patients were enrolled between 2014 August and 2017 May. Primary endpoint of this study was target vessel failure (TVF) at 3 years, including cardiac death, target-vessel-related myocardial infarction, and clinically-driven target vessel revascularization.Results:ACS was present in 1 136 (78.5%) patients, and 3-year clinical follow-up was available in 1 423 patients (98.3%). TVF in the ACS group was 9.6% (109/1 136), which was significantly higher than 4.5% (14/312) in the non-ACS group (log-rank P=0.005). There were 109 TVFs in the ACS patients, with 7.6% (43/569) TVFs in the IVUS group and 11.6% (66/567) TVFs in the angiography group (log-rank P=0.019). Moreover, patients with optimal IVUS guidance were associated with a lower risk of 3-year TVF compared to those with suboptimal IVUS results (5.4% (16/296) vs. 9.9% (27/273),log-rank P=0.041). Conclusions:This ULTIMATE-ACS subgroup analysis showed that ACS patients undergoing DES implantation were associated with a higher risk of 3-year TVF. More importantly, the risk of TVF could be significantly decreased through IVUS guidance in patients with ACS, especially in those who had an IVUS-defined optimal procedure.
