دورية أكاديمية
Effect of negative remodeling of the side branch ostium on the efficacy of a two-stent strategy for distal left main bifurcation lesions: an intravascular ultrasound study.
| العنوان: | Effect of negative remodeling of the side branch ostium on the efficacy of a two-stent strategy for distal left main bifurcation lesions: an intravascular ultrasound study. |
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| المؤلفون: | Xu Y; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Xu T; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Nong JC; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Kong XH; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Zhao MY; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Gao ZJ; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China.; Department of Cardiology, Clinical Medicine School of Nanjing University, Nanjing, China.; Department of Cardiology, Tianchang People's Hospital, Tianchang, China.; Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China., Wang YF; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., You W; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Meng PN; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Zhou YH; Department of Cardiology, Clinical Medicine School of Nanjing University, Nanjing, China., Wu XQ; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Wu ZM; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China., Zhan ME; Department of Cardiology, Tianchang People's Hospital, Tianchang, China., Wang YQ; Department of Cardiology, Clinical Medicine School of Nanjing University, Nanjing, China., Pan DF; Department of Cardiology, the Affiliated Hospital of Xuzhou Medical University, Xuzhou, China., Ye F; Department of Cardiology, Nanjing First Hospital, Nanjing Hospital Affiliated to Nanjing Medical University, Nanjing Medical University, Nanjing, China. |
| المصدر: | Journal of geriatric cardiology : JGC [J Geriatr Cardiol] 2024 May 28; Vol. 21 (5), pp. 506-522. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Institute of Geriatric Cardiology, Chinese PLA General Hospital Country of Publication: China NLM ID: 101237881 Publication Model: Print Cited Medium: Print ISSN: 1671-5411 (Print) Linking ISSN: 16715411 NLM ISO Abbreviation: J Geriatr Cardiol Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Beijing, China : Institute of Geriatric Cardiology, Chinese PLA General Hospital |
| مستخلص: | Objectives: To investigate whether negative remodeling (NR) detected by intravascular ultrasound (IVUS) of the side branch ostium (SBO) would affect in-stent neointimal hyperplasia (NIH) at the one-year follow-up and the clinical outcome of target lesion failure (TLF) at the long-term follow-up for patients with left main bifurcation (LMb) lesions treated with a two-stent strategy. Methods: A total of 328 patients with de novo true complex LMb lesions who underwent a 2-stent strategy of percutaneous coronary intervention (PCI) treatment guided by IVUS were enrolled in this study. We divided the study into two phases. Of all the patients, 48 patients who had complete IVUS detection pre- and post-PCI and at the 1-year follow-up were enrolled in phase I analysis, which aimed to analyze the correlation between NR and in-stent NIH at SBO at the 1-year follow-up. If the correlation was confirmed, the cutoff value of the remodeling index (RI) for predicting NIH ≥ 50% was analyzed next. The phase II analysis focused on the incidence of TLF as the primary endpoint at the 1- to 5-year follow-up for all 328 patients by grouping based on the cutoff value of RI. Results: In phase I: according to the results of a binary logistic regression analysis and receiver operating characteristic (ROC) analysis, the RI cutoff value predicting percent NIH ≥ 50% was 0.85 based on the ROC curve analysis, with a sensitivity of 85.7%, a specificity of 88.3%, and an AUC of 0.893 (0.778, 1.000), P = 0.002. In phase II: the TLR rate (35.8% vs. 5.3%, P < 0.0001) was significantly higher in the several NR (sNR, defined as RI ≤ 0.85) group than in the non-sNR group. Conclusion: The NR of LCxO is associated with more in-stent NIH post-PCI for distal LMb lesions with a 2-stent strategy, and NR with RI ≤ 0.85 is linked to percent NIH area ≥ 50% at the 1-year follow-up and more TLF at the 5-year follow-up. Competing Interests: All authors have nothing to disclose. (© 2024 JGC All rights reserved; www.jgc301.com.) |
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| تواريخ الأحداث: | Date Created: 20240701 Latest Revision: 20240702 |
| رمز التحديث: | 20240702 |
| مُعرف محوري في PubMed: | PMC11211904 |
| DOI: | 10.26599/1671-5411.2024.05.003 |
| PMID: | 38948898 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 1671-5411 |
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| DOI: | 10.26599/1671-5411.2024.05.003 |