Quantitative Coronary Angiography vs Intravascular Ultrasonography to Guide Drug-Eluting Stent Implantation

作者：Pil Hyung Lee, Soon Jun Hong, H S Kim, Young Won Yoon, Jong‐Young Lee, Seung‐Jin Oh, Ji Sung Lee, Soo‐Jin Kang, Young‐Hak Kim, Seong‐Wook Park, Seung‐Whan Lee, Cheol Whan Lee, Sung-cheol Yoon, Jae‐Hyeong Park, Jong‐Min Song, So-Yeon Choi, Tae Oh Kim, Ju Hyeon Kim, A-Ram Kim Kim, Mi Jin Kim, Ho Yun Kim, Jin‐Sun Park, Jinho Lee, Yeon Woo Choi, Hojung Kang, Seon Bae Kim, Ju Hee Kim, Hea Young Yun, Ho Jung Kim, Jin Seok Roh, Han Seong Bea, Min Suk Lee, Jiwon Baek, Yoon Won Lee, Moon Un Song, Tae Yeon Kim, Ha Jun Lee, Joon Won Kang, Jin Woo Nam, Tae‐Hoon Kim, Min Soo Cho, In kyoung Kuk, Gi Won Kim, Hun Jeong, Yong Hak Shin, Seung Hyun Lee, Young Joon Shin, Mi‐Hyun Kim, Tak Chung, Joon Gun Song, Ga Young Pyo, Tae Woo Kim, Dong Oh Lee, Man Ki Chae, Sung Kwang Jun, Ji Yu Han, In Ah Yu, Sooyeon Lee, Sumin Jung, Young Seon Yoon, Kyung Jin Park, Min Hye Park · 发表于：JAMA Cardiology · 年份：2024 · DOI：10.1001/jamacardio.2024.0059 · 被引用次数：44 · 研究领域：Coronary Interventions and Diagnostics、Cardiac Imaging and Diagnostics、Ultrasound and Hyperthermia Applications

Importance: Although intravascular ultrasonography (IVUS) guidance promotes favorable outcomes after percutaneous coronary intervention (PCI), many catheterization laboratories worldwide lack access. Objective: To investigate whether systematic implementation of quantitative coronary angiography (QCA) to assist angiography-guided PCI could be an alternative strategy to IVUS guidance during stent implantation. Design, Setting, and Participants: This randomized, open-label, noninferiority clinical trial enrolled adults (aged ≥18 years) with chronic or acute coronary syndrome and angiographically confirmed native coronary artery stenosis requiring PCI. Patients were enrolled in 6 cardiac centers in Korea from February 23, 2017, to August 23, 2021, and follow-up occurred through August 25, 2022. All principal analyses were performed according to the intention-to-treat principle. Interventions: After successful guidewire crossing of the first target lesion, patients were randomized in a 1:1 ratio to receive either QCA- or IVUS-guided PCI. Main Outcomes and Measures: The primary outcome was target lesion failure at 12 months, defined as a composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization. The trial was designed assuming an event rate of 8%, with the upper limit of the 1-sided 97.5% CI of the absolute difference in 12-month target lesion failure (QCA-guided PCI minus IVUS-guided PCI) to be less than 3.5 percentage poi...