Long-term outcomes of intravascular ultrasound-guided percutaneous coronary intervention versus coronary artery bypass grafting for multivessel coronary artery disease
Issued Date
2025-01-01
Resource Type
ISSN
13556037
eISSN
1468201X
Scopus ID
2-s2.0-105005434349
Journal Title
Heart
Rights Holder(s)
SCOPUS
Bibliographic Citation
Heart (2025)
Suggested Citation
Lee J., Ahn J.M., Kim H., Choi Y., Jo S., Kang D.Y., Kim M.J., Hur S.H., Park H.J., Tresukosol D., Kang W.C., Kwon H.M., Rha S.W., Lim D.S., Jeong M.H., Lee B.K., Huang H., Lim Y.H., Bae J.H., Kim B.O., Ong T.K., Ahn S.G., Chung C.H., Park D.W., Park S.J. Long-term outcomes of intravascular ultrasound-guided percutaneous coronary intervention versus coronary artery bypass grafting for multivessel coronary artery disease. Heart (2025). doi:10.1136/heartjnl-2024-325107 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/110355
Title
Long-term outcomes of intravascular ultrasound-guided percutaneous coronary intervention versus coronary artery bypass grafting for multivessel coronary artery disease
Author's Affiliation
The Catholic University of Korea Seoul St. Mary's Hospital
Korea University Guro Hospital
Chonnam National University Hospital
Korea University Anam Hospital
Hanyang University Hospital
Gachon University
Siriraj Hospital
Wonju Severance Christian Hospital
Gangnam Severance Hospital
Keimyung University, Dongsan Medical Center
Inje University Paik Hospital
Asan Medical Center
Zhejiang University School of Medicine
Kyung Hee Medical Center
Dong-A University, College of Medicine
Konyang University, College of Medicine
Kangwon National University
Changwon Hanmaeum Hospital
Sejong General Hospital
Sarawak Heart Centre
Korea University Guro Hospital
Chonnam National University Hospital
Korea University Anam Hospital
Hanyang University Hospital
Gachon University
Siriraj Hospital
Wonju Severance Christian Hospital
Gangnam Severance Hospital
Keimyung University, Dongsan Medical Center
Inje University Paik Hospital
Asan Medical Center
Zhejiang University School of Medicine
Kyung Hee Medical Center
Dong-A University, College of Medicine
Konyang University, College of Medicine
Kangwon National University
Changwon Hanmaeum Hospital
Sejong General Hospital
Sarawak Heart Centre
Corresponding Author(s)
Other Contributor(s)
Abstract
Background Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) has been shown to improve outcomes in complex coronary artery disease compared with angiography-guided PCI. However, long-term comparisons between IVUS-guided PCI and coronary artery bypass grafting (CABG) for multivessel disease (MVD) remain limited. Methods This post hoc analysis of the Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment Extended Follow-up study included 880 patients with MVD, excluding 15 patients who received medical therapy. Patients were categorised into IVUS-guided PCI (n=333), angiography-guided PCI (n=131) and CABG (n=401). The primary endpoint was the composite of death, myocardial infarction (MI) or target-vessel revascularisation over a median follow-up of 11.8 years. Results The IVUS-guided PCI group showed no difference in the primary endpoint compared with CABG (adjusted HR 1.013; 95% CI 0.747 to 1.374; p=0.93). In contrast, angiography-guided PCI was associated with a higher risk of clinical events (adjusted HR 2.231; 95% CI 1.582 to 3.145; p<0.001). The safety endpoint (composite of death, MI and stroke) did not differ between IVUS-guided PCI and CABG (adjusted HR 0.845; 95% CI 0.605 to 1.181; p=0.324), while angiography-guided PCI was associated with a higher risk (adjusted HR 2.016; 95% CI 1.405 to 2.895; p<0.001). Both PCI groups had higher rates of repeat revascularisation compared with CABG. Conclusions IVUS-guided PCI demonstrated comparable long-term outcomes to CABG in terms of mortality and safety endpoints, supporting its use in the treatment of MVD. These findings highlight the potential benefits of IVUS guidance in complex PCI procedures.