Optimal Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Patients With Multivessel Disease and Left Ventricular Dysfunction.

Circulation reports Pub Date : 2025-03-06 eCollection Date: 2025-04-10 DOI:10.1253/circrep.CR-25-0005

Ko Yamamoto, Hiroki Shiomi, Ryusuke Nishikawa, Takeshi Morimoto, Akiyoshi Miyazawa, Toru Naganuma, Satoru Suwa, Takanari Fujita, Takenori Domei, Shojiro Tatsushima, Akihiro Takasaki, Akihiro Kikuchi, Atsunori Okamura, Nobuhiro Suematsu, Tsuyoshi Isawa, Shintaro Honda, Yoshiaki Kawase, Kazushige Kadota, Kenji Ando, Kiyoshi Hibi, Koh Ono, Takeshi Kimura

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Abstract

Background: Data on clinical outcomes after intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) in patients with multivessel disease and left ventricular (LV) dysfunction are scarce.

Methods and results: The OPTIVUS-Complex PCI study multivessel cohort was a prospective multicenter single-arm trial enrolling 1,010 patients undergoing multivessel IVUS-guided PCI including left anterior descending coronary artery target with an intention to meet the prespecified OPTIVUS criteria for optimal stent expansion. We compared clinical outcomes between patients with and without LV dysfunction. The primary endpoint was a composite of death, myocardial infarction, stroke, any coronary revascularization, or hospitalization for heart failure. There were 763 patients (75.5%) with preserved LV function (LV ejection fraction [LVEF] >50%), 176 patients (17.4%) with moderate LV dysfunction (35

Conclusions: Among patients undergoing multivessel IVUS-guided PCI with contemporary practice, 1-year clinical outcomes were worse in patients with LV dysfunction.

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超声引导下经皮冠状动脉介入治疗多血管疾病和左心室功能不全患者的最佳方法。

背景：血管内超声（IVUS）引导下经皮冠状动脉介入治疗（PCI）多血管疾病合并左心室功能不全患者的临床结果资料很少。方法和结果：OPTIVUS- complex PCI研究多血管队列是一项前瞻性多中心单臂试验，纳入了1010名接受多血管ivus引导的PCI治疗的患者，包括冠状动脉左前降支靶，目的是满足预先指定的OPTIVUS标准，以达到最佳支架扩张。我们比较了有和没有左室功能障碍患者的临床结果。主要终点为死亡、心肌梗死、中风、任何冠状动脉血运重建术或因心力衰竭住院。763例（75.5%）左室功能保留（左室射血分数[LVEF]低于50%），176例（17.4%）中度左室功能不全（35）。结论：在当代实践中接受多血管ivus引导的左室功能不全患者中，左室功能不全患者1年临床预后较差。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Circulation reports

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