Division of Cardiology, Department of Internal Medicine, Memorial Heart Center, Iwate Medical University, 19-1, Uchimaru, Morioka City, Iwate, Japan.
Department of Cardiology, Edogawa Hospital, 2-24-28, Higashikoiwa, Edogawa-ku, Tokyo, Japan.
Int J Cardiovasc Imaging. 2019 Nov;35(11):1979-1987. doi: 10.1007/s10554-019-01657-y. Epub 2019 Jun 29.
The purpose of this study was to clarify a cut-off value for acute incomplete stent apposition (ISA) volume and maximum-depth to predict ISA resolution at 1- and 3-month follow-up in patients treated with cobalt-chromium everolimus-eluting stents. In total, 95 cases and 103 stents were registered in the MECHANISM-Elective sub-study. Acute ISA-volume was measured by the trapezoid rule. ISA resolution of cut-off value at 1- and 3-month was estimated by ISA-volume and maximum-depth using receiver operatorating characteristic curve analysis. The total number of analysed acute ISAs was 202 in the 1-month group and 225 in the 3-month group. A total of 123 ISAs at 1-month and a total of 169 ISAs at 3-month had been resolved. The cut-off value of ISA resolution by ISA-volume was 0.169 mm at 1-month (AUC: 0.725, sensitivity: 72.2%, specificity: 61.0%) and 0.295 mm at 3-month (AUC: 0.757, sensitivity: 75.0%, specificity: 60.4%). The cut-off value of ISA resolution by ISA maximum-depth demonstrated was 0.285 mm at 1-month (area under curve (AUC): 0.789, sensitivity: 70.9%, specificity: 69.9%) and 0.305 mm at 3-month (AUC: 0.663, sensitivity: 60.7%, specificity: 66.9%). Incidence of ISA resolution was significantly lower in combination with cut-off values of ISA-volume and maximum-depth (33%, p < 0.001, at 1-month; 56%, p = 0.003, at 3-month). Combining the cut-off value of ISA-volume with the maximum-depth might be helpful to consider the endpoint of the PCI procedure.
本研究旨在明确急性不完全支架贴壁(ISA)体积和最大深度的截断值,以预测接受钴铬依维莫司洗脱支架治疗的患者在 1 个月和 3 个月随访时的 ISA 缓解情况。共纳入 MECHANISM-Elective 子研究 95 例和 103 个支架。采用梯形法则测量急性 ISA 体积。通过受试者工作特征曲线分析 ISA 体积和最大深度评估 1 个月和 3 个月时的截断值预测 ISA 缓解。1 个月组共分析了 202 个急性 ISA,3 个月组共分析了 225 个急性 ISA。1 个月时共有 123 个 ISA 缓解,3 个月时共有 169 个 ISA 缓解。ISA 体积预测 1 个月时 ISA 缓解的截断值为 0.169mm(AUC:0.725,敏感性:72.2%,特异性:61.0%),3 个月时为 0.295mm(AUC:0.757,敏感性:75.0%,特异性:60.4%)。ISA 最大深度预测 1 个月时 ISA 缓解的截断值为 0.285mm(AUC:0.789,敏感性:70.9%,特异性:69.9%),3 个月时为 0.305mm(AUC:0.663,敏感性:60.7%,特异性:66.9%)。ISA 体积和最大深度联合截断值时 ISA 缓解发生率明显降低(1 个月时为 33%,p<0.001;3 个月时为 56%,p=0.003)。联合 ISA 体积和最大深度的截断值可能有助于考虑 PCI 治疗的终点。