title: Meta-analysis of angiographic versus intravascular ultrasound parameters of drug-eluting stent efficacy (from TAXUS IV, V, and VI).
abstract: Both quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) are currently used to assess in-stent restenosis. This study aimed to use standardized imaging and clinical follow-up to compare QCA parameters with several IVUS parameters to evaluate their strengths and weaknesses for detecting in-stent restenosis in a drug-eluting stent population. A subset of patients from the TAXUS IV, V, and VI studies was evaluated. The subset, which included 216 TAXUS-treated patients and 191 bare-metal stent-treated patients, had complete IVUS and QCA performed at baseline and follow-up. As expected, all QCA and IVUS parameters were consistent with less intimal hyperplasia in TAXUS patients than controls. The overall incidence of QCA binary restenosis was 14.0%, which was 9.3% in TAXUS-treated patients and 19% in bare-metal stent-treated patients (p = 0.0008). Regression analysis showed that QCA late lumen loss and percentage of diameter stenosis correlated only moderately with the various IVUS measures of neointimal hyperplasia for the combined group of patients (TAXUS + bare-metal stent), as well as for the TAXUS-treated and bare-metal stent-treated patients separately. However, in general, correlations within the control (bare-metal stent) group tended to be stronger than within the TAXUS group. The strongest correlation was between QCA percentage of diameter stenosis and IVUS percentage of intimal hyperplasia in the overall group and the control group. The strongest IVUS predictor of QCA binary restenosis at 9 months was maximum percentage of intimal hyperplasia, with an overall C = 0.91 and p <0.001. In conclusion, the QCA and IVUS parameters used to evaluate drug-eluting stent efficacy showed a moderate correlation with IVUS percentage of intimal hyperplasia, reliably predicting QCA binary in-stent restenosis.
authors: Cardiovascular Research Institute/Medstar Research Institute, Washington Hospital Center, Washington, DC, USA.
authors: Esteban
authors: E
authors: Escolar
authors: Gary S
authors: GS
authors: Mintz
authors: Jeffrey
authors: J
authors: Popma
authors: Aleksandra
authors: A
authors: Michalek
authors: Sang Wook
authors: SW
authors: Kim
authors: Lazar
authors: L
authors: Mandinov
authors: Joerg
authors: J
authors: Koglin
authors: Gregg
authors: G
authors: Stone
authors: Stephen G
authors: SG
authors: Ellis
authors: Eberhard
authors: E
authors: Grube
authors: Keith D
authors: KD
authors: Dawkins
authors: Neil J
authors: NJ
authors: Weissman
mesh_terms: D019917:Blood Vessel Prosthesis Implantation / Q000295:instrumentation*; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis*; D019160:Endosonography; D006801:Humans; D011475:Prosthesis Failure; D015203:Reproducibility of Results; D015607:Stents
chemical_list: D020099:Coated Materials, Biocompatible