Korean Circulation Journal

  • 제44권3호
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  • Pages.148-155
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  • 2014
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  • 1738-5520(pISSN)
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  • 1738-5555(eISSN)
대한심장학회 (The Korean Society of Cardiology)
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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)
  • 투고 : 2014.01.05
  • 심사 : 2014.02.21
  • 발행 : 2014.03.30
⟨ 이전 논문 다음 논문 ⟩

초록

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.

키워드

참고문헌

  1. Briguori C, Anzuini A, Airoldi F, et al. Intravascular ultrasound criteria for the assessment of the functional significance of intermediate coronary artery stenoses and comparison with fractional flow reserve. Am J Cardiol 2001;87:136-41. https://doi.org/10.1016/S0002-9149(00)01304-7
  2. Tobis J, Azarbal B, Slavin L. Assessment of intermediate severity coronary lesions in the catheterization laboratory. J Am Coll Cardiol 2007; 49:839-48. https://doi.org/10.1016/j.jacc.2006.10.055
  3. Abizaid A, Mintz GS, Pichard AD, et al. Clinical, intravascular ultrasound, and quantitative angiographic determinants of the coronary flow reserve before and after percutaneous transluminal coronary angioplasty. Am J Cardiol 1998;82:423-8. https://doi.org/10.1016/S0002-9149(98)00355-5
  4. Pijls NH, Van Gelder B, Van der Voort P, et al. Fractional flow reserve. A useful index to evaluate the influence of an epicardial coronary stenosis on myocardial blood flow. Circulation 1995;92:3183-93. https://doi.org/10.1161/01.CIR.92.11.3183
  5. Pijls NH, De Bruyne B, Peels K, et al. Measurement of fractional flow reserve to assess the functional severity of coronary-artery stenoses. N Engl J Med 1996;334:1703-8. https://doi.org/10.1056/NEJM199606273342604
  6. Baumgart D, Haude M, Goerge G, et al. Improved assessment of coronary stenosis severity using the relative flow velocity reserve. Circulation 1998;98:40-6. https://doi.org/10.1161/01.CIR.98.1.40
  7. Ahn JM, Kang SJ, Mintz GS, et al. Validation of minimal luminal area measured by intravascular ultrasound for assessment of functionally significant coronary stenosis comparison with myocardial perfusion imaging. JACC Cardiovasc Interv 2011;4:665-71. https://doi.org/10.1016/j.jcin.2011.02.013
  8. Koo BK, Yang HM, Doh JH, et al. Optimal intravascular ultrasound criteria and their accuracy for defining the functional significance of intermediate coronary stenoses of different locations. JACC Cardiovasc Interv 2011;4:803-11. https://doi.org/10.1016/j.jcin.2011.03.013
  9. Kang SJ, Lee JY, Ahn JM, et al. Intravascular ultrasound-derived predictors for fractional flow reserve in intermediate left main disease. JACC Cardiovasc Interv 2011;4:1168-74. https://doi.org/10.1016/j.jcin.2011.08.009
  10. Dhawan J, Bray CL. Are Asian coronary arteries smaller than Caucasian? A study on angiographic coronary artery size estimation during life. Int J Cardiol 1995;49:267-9. https://doi.org/10.1016/0167-5273(95)02315-N
  11. Lip GY, Rathore VS, Katira R, Watson RD, Singh SP. Do Indo-Asians have smaller coronary arteries? Postgrad Med J 1999;75:463-6. https://doi.org/10.1136/pgmj.75.886.463
  12. Effects of tissue plasminogen activator and a comparison of early invasive and conservative strategies in unstable angina and non-Q-wave myocardial infarction. Results of the TIMI IIIB Trial. Thrombolysis in Myocardial Ischemia. Circulation 1994;89:1545-56. https://doi.org/10.1161/01.CIR.89.4.1545
  13. Mintz GS, Nissen SE, Anderson WD, et al. American College of Cardiol ogy Clinical Expert Consensus Document on Standards for Acquisition, Measurement and Reporting of Intravascular Ultrasound Studies (IVUS). A report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. J Am Coll Cardiol 2001;37: 1478-92. https://doi.org/10.1016/S0735-1097(01)01175-5
  14. Stone GW, Maehara A, Lansky AJ, et al. A prospective natural-history study of coronary atherosclerosis. N Engl J Med 2011;364:226-35. https://doi.org/10.1056/NEJMoa1002358
  15. Nicholls SJ, Tuzcu EM, Kalidindi S, et al. Effect of diabetes on progression of coronary atherosclerosis and arterial remodeling: a pooled analysis of 5 intravascular ultrasound trials. J Am Coll Cardiol 2008; 52:255-62. https://doi.org/10.1016/j.jacc.2008.03.051
  16. Boyle PJ. Diabetes mellitus and macrovascular disease: mechanisms and mediators. Am J Med 2007;120(9 Suppl 2):S12-7.
  17. Takayama T, Hiro T, Ueda Y, et al. Plaque stabilization by intensive LDLcholesterol lowering therapy with atorvastatin is delayed in type 2 diabetic patients with coronary artery disease-Serial angioscopic and intravascular ultrasound analysis. J Cardiol 2013;61:381-6. https://doi.org/10.1016/j.jjcc.2013.01.010
  18. Stancoven A, McGuire DK. Preventing macrovascular complications in type 2 diabetes mellitus: glucose control and beyond. Am J Cardiol 2007;99(11A):5H-11H. https://doi.org/10.1016/S0002-9149(07)00581-4
  19. Nissen SE, Tuzcu EM, Schoenhagen P, et al. Statin therapy, LDL cholesterol, C-reactive protein, and coronary artery disease. N Engl J Med 2005;352:29-38. https://doi.org/10.1056/NEJMoa042000
  20. Nissen SE, Nicholls SJ, Sipahi I, et al. Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial. JAMA 2006;295:1556-65. https://doi.org/10.1001/jama.295.13.jpc60002
  21. Nicholls SJ, Tuzcu EM, Sipahi I, et al. Statins, high-density lipoprotein cholesterol, and regression of coronary atherosclerosis. JAMA 2007; 297:499-508. https://doi.org/10.1001/jama.297.5.499
  22. Hong YJ, Jeong MH, Ahn Y, et al. Effect of pitavastatin treatment on changes of plaque volume and composition according to the reduction of high-sensitivity C-reactive protein levels. J Cardiol 2012;60: 277-82. https://doi.org/10.1016/j.jjcc.2012.04.003

피인용 문헌

  1. Acute Myocardial Infarction Occurring at a Preexisting Intermediate Coronary Artery Stenosis vol.89, pp.4, 2014, https://doi.org/10.3904/kjm.2015.89.4.448