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KMID : 0368120140440030148
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Korean Circulation Journal
2014 Volume.44 No. 3 p.148 ~ p.155
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Clinical Outcomes in Patients with Intermediate Coronary Stenoses: MINIATURE Investigators (Korea MultIceNter TrIal on Long-Term Clinical Outcome According to the Plaque Burden and Treatment Strategy in Lesions with MinimUm Lumen ARea lEss Than 4 mm2 Using Intravascular Ultrasound)
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Hong Young-Joon
Choi Yun-Ha
Park Soo-Young
Nam Chang-Wook
Cho Jang-Hyun
Lee Sang-Rok
Lee Sung-Yun
Kim Sang-Wook
Lim Sang-Yeob
Yun Kyung-Ho
Kim Jung-Sun
Kim Jin-Won
Kang Woong-Chol
Kim Ki-Seok
Choi Jin-Ho
Kim Soo-Joong
Chung Joong-Wha
Ahn Young-Keun
Jeong Myung-Ho
Kang Won-Yu
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Abstract
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Background and Objectives: We evaluated the two-year clinical outcomes in patients with angiographically intermediate lesions according to the plaque burden and treatment strategy.
Subjects and Methods: We prospectively enrolled patients with angiographically intermediate lesions (diameter stenosis 30-70%) with an intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm2 with 50-70% plaque burden of 16 Korean percutaneous coronary intervention centers. Patients were divided into medical therapy group (n=85) and zotarolimus-eluting stent group (ZES; Resolute) group (n=74). We evaluated the incidences of two-year major adverse cardiovascular events (MACE).
Results: A two-year clinical follow-up was completed in 143 patients and MACE occurred in 12 patients. There were no significant differences in the incidences of death (1.3% vs. 3.0%, p=0.471), target vessel-related non-fatal myocardial infarction (0.0% vs. 0.0%, p=1.000) and target vessel revascularizations (7.8% vs. 4.5%, p=0.425) between medical and ZES groups. Independent predictors of two-year MACE included acute myocardial infarction {odds ratio (OR)=2.87; 95% confidence interval (CI) 1.43-6.12, p=0.014}, diabetes mellitus (OR=2.46; 95% CI 1.24-5.56, p=0.028) and non-statin therapy (OR=2.32; 95% CI 1.18-5.24, p=0.034).
Conclusion: Medical therapy shows comparable results with ZES, and myocardial infarction, diabetes mellitus and non-statin therapy were associated with the occurrence of two-year MACE in patients with intermediate lesion with IVUS MLA <4 mm2 with 50-70% of plaque burden.
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KEYWORD
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Coronary artery disease, Atherosclerotic plaque, Intravascular ultrasonography
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