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Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
Heart and Vascular Theme, Karolinska University Hospital, Unit of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Department of Cardiology, Clinical Sciences, Lund University, Skåne University Hospital, Lund, Sweden.
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2023 (English)In: Journal of the Society for Cardiovascular Angiography & Interventions, ISSN 2772-9303, Vol. 2, no 3, article id 100597Article in journal (Refereed) Published
Abstract [en]

Background: Current evidence suggests that use of intracoronary imaging during percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA) reduces mortality. However, there is a scarcity of data on the overall role of intracoronary imaging, particularly in other non-LMCA proximal coronary artery lesions. We aimed to investigate the association of use of intracoronary imaging on outcome in proximal lesions treated with PCI.

Methods: The Swedish Coronary Angiography and Angioplasty Registry was used to identify all proximal coronary artery lesions treated with stent implantation between June 11, 2013, and January 16, 2021. Proximal coronary artery lesions (LMCA, proximal left anterior descending artery, left circumflex artery, and right coronary artery) assessed by intracoronary imaging before and/or after stent implantation were matched to control lesions treated based on angiography alone using propensity score matching. The primary end point was target lesion revascularization with PCI, and secondary end points included all-cause mortality and definite stent thrombosis within 3 years.

Results: Among the 3623 matched pairs, intracoronary imaging was associated with significantly lower risk of target lesion revascularization, 3.7% vs 4.7%; hazard ratio (HR), 0.77; 95% CI, 0.61-0.97; P = .025, and all-cause mortality, 9.1% vs 12.8%; HR, 0.70; 95% CI, 0.61-0.81; P < .001, with no difference in definite stent thrombosis.

Conclusions: The use of intracoronary imaging in proximal coronary artery lesions is associated with lower rates of repeat revascularization and better survival. The results appear to be primarily driven by improved outcome of LMCA lesions. These results reinforce the role of intracoronary imaging in assessing and treating proximal coronary lesions.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 2, no 3, article id 100597
Keywords [en]
intracoronary imaging, intravascular ultrasound, optical coherence tomography, target lesion revascularization
National Category
Cardiology and Cardiovascular Disease
Identifiers
URN: urn:nbn:se:oru:diva-110208DOI: 10.1016/j.jscai.2023.100597Scopus ID: 2-s2.0-85159306610OAI: oai:DiVA.org:oru-110208DiVA, id: diva2:1819170
Funder
Swedish Heart Lung FoundationKnut and Alice Wallenberg Foundation
Note

This work was supported by The Swedish Heart-Lung Foundation, Knut and Alice Wallenberg Foundation, ALF, Skane University Hospital funds, Märta Winkler Foundation, Thorsten Westerströms Foundation,and the Anna-Lisa and Sven-Eric Lundgren Foundation for Medical Research. 

Available from: 2023-12-13 Created: 2023-12-13 Last updated: 2025-02-10Bibliographically approved

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