title: Long-term safety and feasibility of three-vessel multimodality intravascular imaging in patients with ST-elevation myocardial infarction: the IBIS-4 (integrated biomarker and imaging study) substudy.
abstract: We assessed the feasibility and the procedural and long-term safety of intracoronary (i.c) imaging for documentary purposes with optical coherence tomography (OCT) and intravascular ultrasound (IVUS) in patients with acute ST-elevation myocardial infarction (STEMI) undergoing primary PCI in the setting of IBIS-4 study. IBIS4 (NCT00962416) is a prospective cohort study conducted at five European centers including 103 STEMI patients who underwent serial three-vessel coronary imaging during primary PCI and at 13 months. The feasibility parameter was successful imaging, defined as the number of pullbacks suitable for analysis. Safety parameters included the frequency of peri-procedural complications, and major adverse cardiac events (MACE), a composite of cardiac death, myocardial infarction (MI) and any clinically-indicated revascularization at 2 years. Clinical outcomes were compared with the results from a cohort of 485 STEMI patients undergoing primary PCI without additional imaging. Imaging of the infarct-related artery at baseline (and follow-up) was successful in 92.2% (96.6%) of patients using OCT and in 93.2% (95.5%) using IVUS. Imaging of the non-infarct-related vessels was successful in 88.7% (95.6%) using OCT and in 90.5% (93.3%) using IVUS. Periprocedural complications occurred <2.0% of OCT and none during IVUS. There were no differences throughout 2 years between the imaging and control group in terms of MACE (16.7 vs. 13.3%, adjusted HR1.40, 95% CI 0.77-2.52, p = 0.27). Multi-modality three-vessel i.c. imaging in STEMI patients undergoing primary PCI is consistent a high degree of success and can be performed safely without impact on cardiovascular events at long-term follow-up.
authors.affiliation: Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, 3010, Bern, Switzerland.
authors.forename: Masanori
authors.initials: M
authors.lastname: Taniwaki
authors.forename: Maria D
authors.initials: MD
authors.lastname: Radu
authors.forename: Hector M
authors.initials: HM
authors.lastname: Garcia-Garcia
authors.forename: Dik
authors.initials: D
authors.lastname: Heg
authors.forename: Henning
authors.initials: H
authors.lastname: Kelbæk
authors.forename: Lene
authors.initials: L
authors.lastname: Holmvang
authors.forename: Aris
authors.initials: A
authors.lastname: Moschovitis
authors.forename: Stephane
authors.initials: S
authors.lastname: Noble
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pedrazzini
authors.forename: Kari
authors.initials: K
authors.lastname: Saunamäki
authors.forename: Jouke
authors.initials: J
authors.lastname: Dijkstra
authors.forename: Ulf
authors.initials: U
authors.lastname: Landmesser
authors.forename: Peter
authors.initials: P
authors.lastname: Wenaweser
authors.forename: Bernhard
authors.initials: B
authors.lastname: Meier
authors.forename: Giulio G
authors.initials: GG
authors.lastname: Stefanini
authors.forename: Marco
authors.initials: M
authors.lastname: Roffi
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Lorenz
authors.initials: L
authors.lastname: Räber
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000008:administration & dosage; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D054855:Drug-Eluting Stents; D005060:Europe; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008670:Metals; D008875:Middle Aged; D064847:Multimodal Imaging / Q000009:adverse effects / Q000379:methods*; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000401:mortality; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D012307:Risk Factors; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors; D041623:Tomography, Optical Coherence / Q000009:adverse effects; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional / Q000009:adverse effects
chemical_list: D002317:Cardiovascular Agents; D008670:Metals; C518022:umirolimus; D020123:Sirolimus