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Clinical Outcomes in Patients with Intermediate Coronary Stenoses: MINIATURE Investigators (Korea MultIceNter TrIal on Long-Term Clinical Outcome According to the Plaque Burden and Treatment Strategy in Lesions with MinimUm Lumen ARea lEss Than $4mm^2$ Using Intravascular Ultrasound)

  • Hong, Young Joon (Division of Cardiology, Chonnam National University School of Medicine) ;
  • Choi, Yun Ha (Division of Cardiology, Chonnam National University School of Medicine) ;
  • Park, Soo Young (Division of Cardiology, Chonnam National University School of Medicine) ;
  • Nam, Chang Wook (Division of Cardiology, Keimyung University College of Medicine, Dongsan Medical Center) ;
  • Cho, Jang Hyun (Division of Cardiology, Saint Carollo Hospital) ;
  • Kang, Won Yu (Division of Cardiology, Gwangju Veterans Hospital) ;
  • Lee, Sang Rok (Division of Cardiology, Chonbuk National University College of Medicine) ;
  • Lee, Sung Yun (Division of Cardiology, Inje University College of Medicine, Ilsan Paik Hospital) ;
  • Kim, Sang Wook (Division of Cardiology, Chung-Ang University College of Medicine) ;
  • Lim, Sang Yeob (Division of Cardiology, Korea University College of Medicine, Ansan Hospital) ;
  • Yun, Kyung Ho (Division of Cardiology, Wonkwang University College of Medicine) ;
  • Kim, Jung Sun (Division of Cardiology, Yonsei University College of Medicine, Severance Hospital) ;
  • Kim, Jin Won (Division of Cardiology, Korea University Guro Hospital) ;
  • Kang, Woong Chol (Division of Cardiology, Gachon University Gil Medical Center) ;
  • Kim, Ki Seok (Division of Cardiology, Jeju National University College of Medicine) ;
  • Choi, Jin Ho (Division of Cardiology, Samsung Medical Center) ;
  • Chung, Joong Wha (Division of Cardiology, Chosun University College of Medicine) ;
  • Kim, Soo Joong (Division of Cardiology, KyungHee University Medical Center) ;
  • Ahn, Youngkeun (Division of Cardiology, Chonnam National University School of Medicine) ;
  • Jeong, Myung Ho (Division of Cardiology, Chonnam National University School of Medicine)
  • Received : 2014.01.05
  • Accepted : 2014.02.21
  • Published : 2014.03.30

Abstract

Background and Objectives: We evaluated the two-year clinical outcomes in patients with angiographically intermediate lesions according to the plaque burden and treatment strategy. Subjects and Methods: We prospectively enrolled patients with angiographically intermediate lesions (diameter stenosis 30-70%) with an intravascular ultrasound (IVUS) minimum lumen area (MLA) $<4mm^2$ with 50-70% plaque burden of 16 Korean percutaneous coronary intervention centers. Patients were divided into medical therapy group (n=85) and zotarolimus-eluting stent group (ZES; Resolute) group (n=74). We evaluated the incidences of two-year major adverse cardiovascular events (MACE). Results: A two-year clinical follow-up was completed in 143 patients and MACE occurred in 12 patients. There were no significant differences in the incidences of death (1.3% vs. 3.0%, p=0.471), target vessel-related non-fatal myocardial infarction (0.0% vs. 0.0%, p=1.000) and target vessel revascularizations (7.8% vs. 4.5%, p=0.425) between medical and ZES groups. Independent predictors of two-year MACE included acute myocardial infarction {odds ratio (OR)=2.87; 95% confidence interval (CI) 1.43-6.12, p=0.014}, diabetes mellitus (OR=2.46; 95% CI 1.24-5.56, p=0.028) and non-statin therapy (OR=2.32; 95% CI 1.18-5.24, p=0.034). Conclusion: Medical therapy shows comparable results with ZES, and myocardial infarction, diabetes mellitus and non-statin therapy were associated with the occurrence of two-year MACE in patients with intermediate lesion with IVUS MLA $<4mm^2$ with 50-70% of plaque burden.

Keywords

References

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