title: Intravascular Ultrasound Predictors of Major Adverse Cardiovascular Events After Implantation of Everolimus-eluting Stents for Long Coronary Lesions.
abstract: OBJECTIVE
  There are limited data on the usefulness of intravascular ultrasound (IVUS) for long coronary lesions treated with second-generation drug-eluting stents. We evaluated IVUS predictors of major adverse cardiovascular events (MACE) 12 months after implantation of everolimus-eluting stents for long coronary lesions.
  
  
  METHODS
  A total of 804 patients who underwent both postintervention IVUS examination and long everolimus-eluting stent (≥ 28mm in length) implantation were included from 2 randomized trials. MACE was defined as a composite of cardiac death, myocardial infarction, and target-lesion revascularization.
  
  
  RESULTS
  MACE occurred in 24 patients (3.0%) over 12 months. On multivariable Cox regression analysis, independent IVUS predictors of MACE included the postintervention minimum lumen area (MLA) at the target lesion (HR = 0.623; 95%CI, 0.433-0.895; P=.010) and the ratio of MLA/distal reference segment lumen area (HR = 0.744; 95%CI, 0.572-0.969; P=.028). The MLA and MLA-to-distal reference segment lumen area ratio that best predicted patients with MACE from those without these events were 5.0 mm2and 1.0, respectively. Patients with MLA<5.0 mm2or a distal reference segment lumen area had a higher risk of MACE (HR = 6.231; 95%CI, 1.859-20.891; P=.003) than those without MACE.
  
  
  CONCLUSIONS
  Patients with a postintervention IVUS-measured MLA of<5.0 mm2or a distal reference segment lumen area were at risk for MACE after long everolimus-eluting stent implantation.
authors: Department of Internal Medicine, Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Korea.
authors: Seung-Yul
authors: SY
authors: Lee
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Dong-Ho
authors: DH
authors: Shin
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Jung-Sun
authors: JS
authors: Kim
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Byeong-Keuk
authors: BK
authors: Kim
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Young-Guk
authors: YG
authors: Ko
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Donghoon
authors: D
authors: Choi
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
authors: Yangsoo
authors: Y
authors: Jang
authors: Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea; Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea; Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea. Electronic address: mkhong61@yuhs.ac.
authors: Myeong-Ki
authors: MK
authors: Hong
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D023921:Coronary Stenosis / Q000175:diagnosis / Q000601:surgery; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000601:surgery; D000068338:Everolimus / Q000494:pharmacology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D018084:Ultrasonography, Interventional / Q000379:methods*
chemical_list: D007166:Immunosuppressive Agents; D000068338:Everolimus
keywords: Coronary artery disease; Drug-eluting stent; Ecocardiografía intravascular; Enfermedad coronaria; Intravascular ultrasound; Stent farmacoactivo