Abstract 1976: Angiographic versus Intravascular Ultrasound Parameters of Drug-Eluting Stent Efficacy: A Meta-Analysis from TAXUS IV, V and VI
Background: Both quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) are used to assess in-stent restenosis (ISR). However, there is little data regarding the relationship between these two techniques in determining binary restenosis.
Methods: A total of 412 patients (220 TAXUS, 192 control bare metal stents [BMS]) were studied from TAXUS IV, V de novo, and VI. All had identical protocols for implantation and core laboratory assessments, with complete IVUS and QCA at baseline and 9-month follow-up. QCA measurements included late lumen loss (LLL), %DS, and minimum lumen diameter (MLD). Using IVUS, intimal hyperplasia (IH), cross-sectional area (CSA), %IH, lumen CSA, and mean and maximal IH thickness were measured every millimeter throughout the stent. QCA binary ISR was defined as %DS > 50. IVUS binary ISR was defined as maximum %IH > 50. IVUS and QCA predictors of binary ISR were analyzed.
Results: At 9-months, 15% (60/412) of stents met the criteria for QCA binary ISR (18/220 TAXUS [8.1%] and 42/192 BMS [22%], p < 0.0001). Criteria for IVUS binary ISR were met in 30% (123/412) of stents (35/220 TAXUS [16%] and 88/192 BMS [46%], p < 0.0001), significantly more than met the criteria for QCA binary ISR (p < 0.0001). While IVUS parameters predicted QCA binary ISR, QCA parameters did not predict IVUS binary ISR (see table⇓).
Conclusion: These results suggest that IVUS assessments of ISR are more sensitive than QCA parameters. In particular, IVUS %IH and minimum lumen CSA reliably predict QCA ISR while QCA parameters do not.