IVUS-guided PCI decreases the risk of in-stent restenosis within 1 year in non-diabetic elderly men

摘要

Background Previous studies have shown that drug-eluting stents(DES)implantation guided by intravascular ultrasound(IVUS)could significantly decreased the major adverse cardiac events(MACEs),stent thrombosis,and in-stent restenosis.However,it is unclear whether IVUS-guided single-vessel implantation in elderly without diabetes reduces the risk in-stent restenosis within 1 year.The purpose of our study was to determine whether IVUS-guided percutaneous coronary intervention(PCI)reduces the risk of in-stent restenosis within 1 year in elderly non-diabetic men.Methods 204 elderly non-diabetic males with unstable angina,aged 60-70 years,were taken into our study.All patients underwent coronary angiography(CAG)and left anterior descending branch DES implantation.After that,100 mg aspirin and 75 mg clopidogrel were taken daily.The patients received routine reexamination in the outpatient department,and coronary angiography was performed one year after PCI.102 patients were assigned to PCI+IVUS group(under IVUS guidance)and 102 patients were assigned to PCI group(without IVUS guidance).Two groups were completely matched by age.Multiple logistic analysis and receiver operating characteristic(ROC)curve were conducted to investigate the prevalence rate of in-stent restenosis and MACEs.Results In the PCI group,the level of lipoprotein(a)[Lp(a)]and low density lipoprotein cholesterol(LDL-C),and the number of smokers were obviously higher than that in the PCI+IVUS group.The instent restenosis rate[4(3.92%)vs.13(12.75%),P=0.040]and the risk of in-stent restenosis(OR:0.298,95%CI:0.092-0.969,P=0.040)in the PCI+IVUS group were significantly lower than that in the PCI group.The ROC curve indicated that IVUS was a sensitive and specific factor to decrease the risk of in-stent restenosis[area under the curve(AUC)=0.66,P=0.049].Conclusions IVUS-guided PCI may be an effective method for reducing instent restenosis within 1 year in non-diabetic elderly men.