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首页> 外文期刊>The American Journal of Cardiology >Usefulness of minimum stent cross sectional area as a predictor of angiographic restenosis after primary percutaneous coronary intervention in acute myocardial infarction (from the HORIZONS-AMI Trial IVUS substudy)
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Usefulness of minimum stent cross sectional area as a predictor of angiographic restenosis after primary percutaneous coronary intervention in acute myocardial infarction (from the HORIZONS-AMI Trial IVUS substudy)

机译：最小支架横截面积在急性心肌梗死初次经皮冠状动脉介入治疗后作为预测血管造影再狭窄的有用性（来自HORIZONS-AMI Trial IVUS子研究）

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摘要

HORIZONS-AMI was a prospective dual-arm randomized trial of different antithrombotic regimens and stent types in patients with ST-segment elevation myocardial infarction. A formal intravascular ultrasound (IVUS) substudy enrolled 464 patients with baseline and 13-month follow-up at 36 centers. Of them, 318 patients with 355 lesions were evaluated for this study. Angiographic restenosis occurred in 45 of 355 lesions (12.7%). Bare-metal stent use (45.5% vs 21.2%, p 0.001) and diabetes mellitus (29.5% vs 10.9%, p 0.001) were more prevalent in patients with versus without restenosis. Postprocedure IVUS minimum lumen area (5.6 mm 2, 5.0 to 6.1, vs 6.7 mm 2, 6.5 to 6.9, p 0.001), minimum stent area (5.7 mm 2, 5.1 to 6.3, vs 6.9 mm 2, 6.6 to 7.1, p 0.001), and reference average lumen area (7.7 mm 2, 6.8 to 8.6, vs 9.7 mm 2, 9.3 to 10.1, p 0.001) were smaller in restenotic versus nonrestenotic lesions. By multivariable analysis, minimum stent area was an independent predictor of angiographic restenosis (odds ratio 0.75, 95% confidence interval 0.61 to 0.93, p = 0.009) in addition to diabetes, bare-metal stent use, and longer stent length. Attenuated plaque behind the stent struts had a trend to predict less binary restenosis (p = 0.07). In conclusion, a smaller IVUS minimum stent area was an independent predictor of angiographic restenosis after primary percutaneous intervention in patients with ST-segment elevation myocardial infarction, similar to patients with stable coronary artery disease.
机译：HORIZONS-AMI是一项针对ST段抬高型心肌梗死患者的不同抗栓治疗方案和支架类型的前瞻性双臂随机试验。正式的血管内超声研究（IVUS）在36个中心招募了464例基线和13个月随访的患者。其中，本研究评估了318个患者，其中355个病变。 355处病变中有45处发生了血管造影再狭窄（12.7％）。与没有再狭窄的患者相比，裸金属支架的使用率（45.5％vs 21.2％，p <0.001）和糖尿病（29.5％vs 10.9％，p <0.001）更为普遍。术后IVUS最小管腔面积（5.6 mm 2，5.0至6.1，vs 6.7 mm 2，6.5至6.9，p <0.001），最小支架面积（5.7 mm 2，5.1至6.3，6.9 mm 2，6.6至7.1，p <0.001），再狭窄病灶和非再狭窄病灶的参考平均管腔面积（7.7 mm 2，6.8至8.6，vs 9.7 mm 2，9.3至10.1，p <0.001）较小。通过多变量分析，除了糖尿病，使用裸金属支架和更长的支架长度之外，最小支架面积是血管造影再狭窄的独立预测因子（几率0.75，95％置信区间0.61至0.93，p = 0.009）。支架撑杆后面的斑块衰减趋势可预测二元再狭窄较少（p = 0.07）。总之，与稳定冠心病患者相似，ST段抬高型心肌梗死患者初次经皮介入治疗后，较小的IVUS最小支架面积是血管造影再狭窄的独立预测指标。

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