학술논문
SYNTAX Score and 1-Year Outcomes in the OPTIVUS-Complex PCI Study Multivessel Cohort.
Document Type
Academic Journal
Author
Gohbara M; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.; Hibi K; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan. Electronic address: hibikiyo@yokohama-cu.ac.jp.; Morimoto T; Department of Clinical Epidemiology, Hyogo College of Medicine, Nishinomiya, Japan.; Kirigaya H; Division of Cardiology, Yokohama City University Medical Center, Yokohama, Japan.; Yamamoto K; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Ono K; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Shiomi H; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Ohya M; Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.; Yamaji K; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.; Watanabe H; Department of Cardiology, Japanese Red Cross Wakayama Medical Center, Wakayama, Japan.; Amano T; Department of Cardiology, Aichi Medical University, Nagakute, Japan.; Morino Y; Division of Cardiology, Department of Internal Medicine, Iwate Medical University, Yahaba, Japan.; Takagi K; Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Centre, Suita, Japan.; Honye J; Department of Cardiovascular Medicine, Kikuna Memorial Hospital, Yokohama, Japan.; Matsuo H; Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan.; Abe M; Department of Cardiology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.; Kadota K; Department of Cardiology, Kurashiki Central Hospital, Kurashiki, Japan.; Ando K; Department of Cardiology, Kokura Memorial Hospital, Kitakyushu, Japan.; Nakao K; Division of Cardiology, Saiseikai Kumamoto Hospital Cardiovascular Center, Kumamoto, Japan.; Sonoda S; Department of Cardiovascular Medicine, Saga University, Saga, Japan.; Suwa S; Department of Cardiology, Juntendo University Shizuoka Hospital, Izunokuni, Japan.; Kawai K; Department of Cardiology, Chikamori Hospital, Kochi, Japan.; Kozuma K; Department of Cardiology, Teikyo University School of Medicine, Tokyo, Japan.; Nakagawa Y; Department of Cardiovascular Medicine, Shiga University of Medical Science, Otsu, Japan.; Ikari Y; Department of Cardiology, Tokai University Hospital, Isehara, Japan.; Nanasato M; Department of Cardiology, Sakakibara Heart Institute, Tokyo, Japan.; Hanaoka K; Hanaoka Seishu Memorial Cardiovascular Clinic, Hokkaido, Japan.; Tanabe K; Division of Cardiology, Mitsui Memorial Hospital, Tokyo, Japan.; Hata Y; Department of Cardiology, Minamino Cardiovascular Hospital, Hachioji, Japan.; Akasaka T; Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.; Kimura T; Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
Source
Publisher: Excerpta Medica Country of Publication: United States NLM ID: 0207277 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1913 (Electronic) Linking ISSN: 00029149 NLM ISO Abbreviation: Am J Cardiol Subsets: MEDLINE
Subject
Language
English
Abstract
Background: The optimal revascularization strategy in patients with multivessel disease and intermediate SYNTAX score (SS) has not been fully elucidated. This study aimed to investigate the clinical outcomes of optimal intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) stratified by SS.
Methods: This was a substudy of the OPTIVUS-Complex PCI study Multivessel Cohort, which aimed to meet the prespecified criteria for optimal stent expansion after IVUS-guided PCI. A total of 1,005 patients were divided into 3 groups according to SS: low, ≤22; intermediate, 23 to 32; and high, ≥33. The primary end points were major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of death, myocardial infarction, stroke, or coronary revascularization.
Results: The cumulative 1-year incidence of the primary end point was significantly higher in patients with high SS than in those with intermediate or low SS (25.0%, 10.9%, and 9.5%, respectively; p = 0.003). This difference was mainly caused by the incidence of coronary revascularization. In the multivariable Cox proportional hazards models, the excess risk of patients with high versus low SS remained significant for the primary end point (hazard ratio 3.19, 95% confidence interval 1.65 to 6.16, p <0.001), whereas the excess risk of patients with intermediate versus low SS was no longer significant (hazard ratio 1.20, 95% confidence interval 0.72 to 2.01, p = 0.46).
Conclusions: After IVUS-guided multivessel PCI, patients with intermediate SS had a similar 1-year risk of MACCE to that of patients with low SS, whereas patients with high SS had a higher 1-year risk of MACCE than those with low SS.
Competing Interests: Declaration of Competing Interest Dr. Hibi reports funding grants from Abbott; lecturer fees from Abbott Medical, Daiichi Sankyo, and Medtronic; research grants from the Research Institute for Production Development and Japan Medical Device Corporation; and scholarship funds from Abbott Medical and Nipro. Dr. Morimoto reports lecturer fees from AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo, Japan Lifeline, Kowa, Toray, and Tsumura; manuscript fees from Bristol-Myers Squibb and Kowa; and participation on the advisory boards of Novartis and Teijin. Dr. Tanabe reports honoraria from Abbott Medical, Boston Scientific, Japan Lifeline, Medtronic, OrbusNeich, and Terumo. Dr. Kimura reports research grants from Abbott Medical and Boston Scientific; honoraria from Abbott Medical, Boston Scientific, Daiichi Sankyo, Sanofi, and Terumo; and participation on the advisory boards of Abbott Medical, Boston Scientific, and Sanofi. The remaining authors declare no conflicts of interest.
(Copyright © 2023 Elsevier Inc. All rights reserved.)
Methods: This was a substudy of the OPTIVUS-Complex PCI study Multivessel Cohort, which aimed to meet the prespecified criteria for optimal stent expansion after IVUS-guided PCI. A total of 1,005 patients were divided into 3 groups according to SS: low, ≤22; intermediate, 23 to 32; and high, ≥33. The primary end points were major adverse cardiac and cerebrovascular events (MACCE) defined as a composite of death, myocardial infarction, stroke, or coronary revascularization.
Results: The cumulative 1-year incidence of the primary end point was significantly higher in patients with high SS than in those with intermediate or low SS (25.0%, 10.9%, and 9.5%, respectively; p = 0.003). This difference was mainly caused by the incidence of coronary revascularization. In the multivariable Cox proportional hazards models, the excess risk of patients with high versus low SS remained significant for the primary end point (hazard ratio 3.19, 95% confidence interval 1.65 to 6.16, p <0.001), whereas the excess risk of patients with intermediate versus low SS was no longer significant (hazard ratio 1.20, 95% confidence interval 0.72 to 2.01, p = 0.46).
Conclusions: After IVUS-guided multivessel PCI, patients with intermediate SS had a similar 1-year risk of MACCE to that of patients with low SS, whereas patients with high SS had a higher 1-year risk of MACCE than those with low SS.
Competing Interests: Declaration of Competing Interest Dr. Hibi reports funding grants from Abbott; lecturer fees from Abbott Medical, Daiichi Sankyo, and Medtronic; research grants from the Research Institute for Production Development and Japan Medical Device Corporation; and scholarship funds from Abbott Medical and Nipro. Dr. Morimoto reports lecturer fees from AstraZeneca, Bristol-Myers Squibb, Daiichi Sankyo, Japan Lifeline, Kowa, Toray, and Tsumura; manuscript fees from Bristol-Myers Squibb and Kowa; and participation on the advisory boards of Novartis and Teijin. Dr. Tanabe reports honoraria from Abbott Medical, Boston Scientific, Japan Lifeline, Medtronic, OrbusNeich, and Terumo. Dr. Kimura reports research grants from Abbott Medical and Boston Scientific; honoraria from Abbott Medical, Boston Scientific, Daiichi Sankyo, Sanofi, and Terumo; and participation on the advisory boards of Abbott Medical, Boston Scientific, and Sanofi. The remaining authors declare no conflicts of interest.
(Copyright © 2023 Elsevier Inc. All rights reserved.)