Abstract 16176: Impact of IVUS-guided PCI for Reducing Adverse Cardiovascular Events -One Year Data From Japanese Multicenter (KICS) Registry
Introduction: Although intravascular ultrasound (IVUS) has been widely used in clinical settings, randomized data demonstrating the effect of IVUS for clinical events are limited. Lately, favorable results of IVUS-guided percutaneous coronary intervention (PCI), compared with Angio-guided PCI, were observed in previous studies.
Hypothesis: In Japanese population, large-scale data will demonstrate the utility of IVUS-guided PCI, especially in terms of mortality.
Methods: The Kumamoto Intervention Conference Study (KICS) is multicenter registry enrolling consecutive patients undergoing PCI in 16 centers in Japan and 6,219 consecutive procedures were enrolled in this registry. To elucidate the impact of IVUS usage, 5,801 subjects after successful PCI with 12-month follow-up data were enrolled.
Results: In overall analysis, higher age, acute coronary syndrome (ACS), urgent PCI, and prior myocardial infarction (MI) were negative predictors for IVUS usage. Critical adverse events (all-cause mortality, cardiac death, nonfatal myocardial infarction and stent thrombosis) during 12-month follow up were significantly lower in the IVUS-guided group than in the Angio-guided group (3.4% vs 6.7%, 16% vs 4.7%, 0.5% vs 1.4%, 0.1% vs 0.2%, p < 0.01, respectively). Regardless of the time of death (< 30 days, or >30 days after PCI), Kaplan-Meier analyses for cardiac death showed a significant difference between the 2 groups. In subgroup analysis, favorable results for IVUS usage in cardiac death were consistent with various patient status (in patients with diabetes, chronic kidny disease, ACS, urgent PCI, bare metal stent and drug eluting stent). Even after adjustment by propensity-score matching with predictive factors for cardiac death, IVUS-guided PCI was associated with lower incidence rate in prognostic events, especially in cardiac death compared with angio-guided PCI (2.1% vs 3.6%, p=0.004).
Conclusions: In Japanese patients treated with IVUS-guided PCI, the rates of adverse cardiovascular events were significantly lower than with angiography-guidance alone, regardless of patient status in PCI, stent type, or comorbid conditions.
Author Disclosures: T. Ikemoto: None. K. Sakamoto: None. T. Yamashita: None. N. Tabata: None. T. Akasaka: None. D. Sueta: None. T. Miyazaki: None. K. Tsujita: None. S. Kojima: None. K. Kaikita: None. S. Hokimoto: None.
- © 2016 by American Heart Association, Inc.