Long-term health outcome and mortality evaluation afterinvasive coronary treatment using drug eluting stents with orwithout the IVUS guidance. Randomized control trial. HOME DESIVUS.
2010
Objective: To assess the role of the intravascular ultrasound
(IVUS) during implantation of Drug-eluting stents (DES) on
long-term outcome in patients with complex coronary artery
disease and high clinical risk profile with special attention
to the development of late stent thrombosis (LST). Methods: Two
hunderd and ten patients were randomly assigned to receive DES
either with (N = 105) or without (N = 105) the IVUS guidance.
Dual antiplatelet treatment was administered for 6 months in
all patients. At 18-month follow-up, the rates of Major adverse
cardiac events (MACEs) (death, myocardial infarction, and
reintervention) were assessed in both groups with special
attention to possible LST. Stent thrombosis was classified
according to Academic Research Consortium (ARC). Results: At
the 18-month follow-up, there was no significant difference
between both groups regarding MACE (11% vs. 12%; P = NS). Stent
thrombosis has occurred in four patients (3.8%) in the group
with and in 6 patients (5.7%; P = NS) in the group without the
IVUS guidance. Conclusions: In our randomized trial we failed
to demonstrate the superiority of the IVUS guidance during DES
implantation over standard high-pressure postdilatation.
However we confirmed worrisome results concerning DES
thrombosis after discontinuation of dual antiplatelet-treatment
with documented stent thrombosis related events in almost 5% of
patients with 50% of mortality in this high-risk clinical
scenario.
Keywords:
- Correction
- Cite
- Save
- Machine Reading By IdeaReader
0
References
51
Citations
NaN
KQI