Utilization of IVUS improves all-cause mortality in patients undergoing invasive coronary angiography.
Coronary angiography
Coronary artery disease
ECAD registry
Intravascular ultrasound
Journal
Atherosclerosis plus
ISSN: 2667-0895
Titre abrégé: Atheroscler Plus
Pays: Netherlands
ID NLM: 9918249514806676
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
09
05
2021
revised:
29
06
2021
accepted:
06
07
2021
entrez:
16
1
2023
pubmed:
8
7
2021
medline:
8
7
2021
Statut:
epublish
Résumé
Available data suggest that the use of IVUS for guidance of percutaneous coronary interventions (PCIs) improves the prognosis of patients undergoing complex interventions. We aimed to examine how the utilization of intravascular ultrasound (IVUS) affects patient survival irrespective of procedure complexity. The present analysis is based on the longitudinal ECAD registry of consecutive patients undergoing coronary angiography between 2004 and 2019. The incidence of death due to any cause was evaluated during a mean follow-up of 3.4 years. Cox regression analysis was used to determine the association of IVUS utilization with incident mortality. Overall, data from 30,814 coronary angiography exams (mean age 64.9 ± 12.5 years, 70.3% male) were included, among which 4991 procedures (16.2%) were guided by IVUS. Utilization of IVUS was associated with a 35% reduction in mortality, independent of traditional risk factors (0.64(0.58-0.71), p < 0.0001). The effect of IVUS on mortality was equally present in patients undergoing IVUS-guided coronary interventions (0.75[0.67-0.84], p < 0.0001) as well as purely diagnostic coronary angiography exams (0.62[0.56-0.72], p < 0.0001). In patients without coronary intervention, IVUS utilization led to a higher frequency of aspirin (82.6% vs. 61.9% for IVUS vs. no IVUS, p < 0.0001) and statin therapy (74.9% vs. 62.5%, p < 0.0001). In a large longitudinal registry cohort of patients undergoing invasive coronary angiography, IVUS utilization was associated with lower long-term mortality. The beneficial role of IVUS utilization on survival was equally present for coronary interventions and diagnostic coronary angiograms. Our results support the use of intravascular imaging for decision making in interventional cardiology.
Sections du résumé
Background and aims
UNASSIGNED
Available data suggest that the use of IVUS for guidance of percutaneous coronary interventions (PCIs) improves the prognosis of patients undergoing complex interventions. We aimed to examine how the utilization of intravascular ultrasound (IVUS) affects patient survival irrespective of procedure complexity.
Methods
UNASSIGNED
The present analysis is based on the longitudinal ECAD registry of consecutive patients undergoing coronary angiography between 2004 and 2019. The incidence of death due to any cause was evaluated during a mean follow-up of 3.4 years. Cox regression analysis was used to determine the association of IVUS utilization with incident mortality.
Results
UNASSIGNED
Overall, data from 30,814 coronary angiography exams (mean age 64.9 ± 12.5 years, 70.3% male) were included, among which 4991 procedures (16.2%) were guided by IVUS. Utilization of IVUS was associated with a 35% reduction in mortality, independent of traditional risk factors (0.64(0.58-0.71), p < 0.0001). The effect of IVUS on mortality was equally present in patients undergoing IVUS-guided coronary interventions (0.75[0.67-0.84], p < 0.0001) as well as purely diagnostic coronary angiography exams (0.62[0.56-0.72], p < 0.0001). In patients without coronary intervention, IVUS utilization led to a higher frequency of aspirin (82.6% vs. 61.9% for IVUS vs. no IVUS, p < 0.0001) and statin therapy (74.9% vs. 62.5%, p < 0.0001).
Conclusions
UNASSIGNED
In a large longitudinal registry cohort of patients undergoing invasive coronary angiography, IVUS utilization was associated with lower long-term mortality. The beneficial role of IVUS utilization on survival was equally present for coronary interventions and diagnostic coronary angiograms. Our results support the use of intravascular imaging for decision making in interventional cardiology.
Identifiants
pubmed: 36644503
doi: 10.1016/j.athplu.2021.07.001
pii: S2667-0895(21)00002-X
pmc: PMC9833231
doi:
Types de publication
Journal Article
Langues
eng
Pagination
10-17Informations de copyright
© 2021 The Authors.
Déclaration de conflit d'intérêts
The authors have no relationship with industry, no conflict of interest to declare.
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