title: Intravascular ultrasound-guided primary percutaneous coronary intervention with drug-eluting stent implantation in patients with ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Studies investigating the clinical outcome of intravascular ultrasound (IVUS)-guided primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI) show conflicting results. The aim of our study was to evaluate whether IVUS-guidedPPCI with drug-eluting stents (DESs) in STEMI patients improves clinical outcome.
  
  
  OBJECTIVE
  IVUS-guided PPCI is superior to angio-guided PPCI.
  
  
  METHODS
  Three hundred forty-one patients who underwent PPCI for STEMI and survived the hospitalization were enrolled in this study. Two hundred sixteen (63.3%) patients were treated with angio-guided PPCI and 125 (36.7%) patients were treated with IVUS-guided PPCI. The primary endpoint was defined as the composite of death, myocardial infarction, target vessel revascularization, and target lesion revascularization at the 3-year follow-up visit.
  
  
  RESULTS
  Male gender, dyslipidemia, and smoking were frequent in the IVUS-guided PPCI group. These patients had a higher rate of radial approach, adjunctive ballooning, thrombectomy, and the use of a glycoprotein IIb/IIIa inhibitor. The number and length of implanted stents were higher in the IVUS-guided PPCI group. The primary end point (18.1% vs 12.8%, P = 0.22) and stent thrombosis (2.8% vs 2.4%, P = 1.00) was not different between the groups.
  
  
  CONCLUSIONS
  In our observational study, IVUS-guided PPCI with DESs in patients with STEMI did not improve clinical outcome or stent thrombosis.
authors: Division of Cardiology, Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, South Korea.
authors: Young Jin
authors: YJ
authors: Youn
authors: Junghan
authors: J
authors: Yoon
authors: Jun-Won
authors: JW
authors: Lee
authors: Sung-Gyun
authors: SG
authors: Ahn
authors: Min-Soo
authors: MS
authors: Ahn
authors: Jang-Young
authors: JY
authors: Kim
authors: Byung-Soo
authors: BS
authors: Yoo
authors: Seung-Hwan
authors: SH
authors: Lee
authors: Kyung-Hoon
authors: KH
authors: Choe
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D054855:Drug-Eluting Stents; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011474:Prosthesis Design; D015641:Radiography, Interventional; D012008:Recurrence; D012042:Registries; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D013927:Thrombosis / Q000209:etiology; D013997:Time Factors; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D010975:Platelet Aggregation Inhibitors