在成像引导的皮肤冠状动脉干预期间,支架优化的比例和临床影响:OCTIVUS试验
Hoyun Kim1, Do-Yoon Kang2, Jung-Min Ahn2
1Division of Cardiology, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea; Department of Cardiology, Sejong Hospital, Bucheon, Korea.
在接受成像指导性皮肤冠状动脉干预 (PCI) 的一半患者中,获得了支架优化. 优化的支架显著减少了目标血管的故障,特别是在光学连贯断层扫描指导下.
科学领域:
- 心血管干预 心血管干预
- 医学成像在心脏病学中的医学成像.
- 干预心脏病学 干预心脏病学
背景情况:
- 关于使用血管内超声波 (IVUS) 或光学连贯断层扫描 (OCT) 指导来优化支架的比例和临床影响的数据有限.
- 穿皮冠状动脉干预 (PCI) 的结果可能会受到支架部署质量的影响.
研究的目的:
- 评估通过IVUS或OCT指导实现支架优化的患者比例.
- 评估支架优化对心血管结果的影响.
主要方法:
- 进行了对OCTIVUS试验的二次分析.
- 根据预定义的支架优化标准,患者被分为优化或非优化组.
- 主要终点是目标血管衰竭 (TVF),这是心脏死亡,目标血管MI或缺血驱动的再血管化的复合.
主要成果:
- 在1,980名患者中,51.6%的患者获得了支架优化,OCT引导的PCI (48.3%) 与IVUS引导的PCI (54.8%) 相比,OCT引导的PCI (48.3%) 的比例较低.
- 在2年随访后,优化组 (3.8%) 与非优化组 (7.5%) 的TVF发病率明显较低 (HR:0.52).
- 在OCT指导的PCI中,TVF优化的好处似乎更大,尽管与成像模式没有显著的相互作用.
结论:
- 大约一半接受成像指导PCI的患者实现了支架优化.
- 支架优化与改善的临床结果有关,特别是减少目标血管衰竭.
- 与IVUS引导的PCI相比,OCT引导的PCI对支架优化对结果的积极影响可能更为明显.
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