Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR

Sacharias von Koch; Sofia Bergman; Pontus Andell; Göran K. Olivecrona; Matthias Götberg; Elmir Omerovic; Ole Fröbert; Sergio Buccheri; Stefan James; Sasha Koul; Moman A. Mohammad; David Erlinge

doi:10.1016/j.jscai.2023.100597

Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR

Sacharias von Koch, Sofia Bergman, Pontus Andell, Göran K. Olivecrona, Matthias Götberg, Elmir Omerovic, Ole Fröbert, Sergio Buccheri, Stefan James, Sasha Koul, Moman A. Mohammad, David Erlinge^*

^*Corresponding author for this work

Department of Clinical Medicine - SDCA-Steno Diabetes Center Aarhus

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

Abstract

Background: Current evidence suggests that use of intracoronary imaging during percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA) reduces mortality. However, there is a scarcity of data on the overall role of intracoronary imaging, particularly in other non-LMCA proximal coronary artery lesions. We aimed to investigate the association of use of intracoronary imaging on outcome in proximal lesions treated with PCI. Methods: The Swedish Coronary Angiography and Angioplasty Registry was used to identify all proximal coronary artery lesions treated with stent implantation between June 11, 2013, and January 16, 2021. Proximal coronary artery lesions (LMCA, proximal left anterior descending artery, left circumflex artery, and right coronary artery) assessed by intracoronary imaging before and/or after stent implantation were matched to control lesions treated based on angiography alone using propensity score matching. The primary end point was target lesion revascularization with PCI, and secondary end points included all-cause mortality and definite stent thrombosis within 3 years. Results: Among the 3623 matched pairs, intracoronary imaging was associated with significantly lower risk of target lesion revascularization, 3.7% vs 4.7%; hazard ratio (HR), 0.77; 95% CI, 0.61-0.97; P = .025, and all-cause mortality, 9.1% vs 12.8%; HR, 0.70; 95% CI, 0.61-0.81; P < .001, with no difference in definite stent thrombosis. Conclusions: The use of intracoronary imaging in proximal coronary artery lesions is associated with lower rates of repeat revascularization and better survival. The results appear to be primarily driven by improved outcome of LMCA lesions. These results reinforce the role of intracoronary imaging in assessing and treating proximal coronary lesions.

Original language	English
Article number	100597
Journal	Journal of the Society for Cardiovascular Angiography and Interventions
Volume	2
Issue	3
DOIs	https://doi.org/10.1016/j.jscai.2023.100597
Publication status	Published - 1 May 2023

Keywords

intracoronary imaging
intravascular ultrasound
optical coherence tomography
target lesion revascularization

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10.1016/j.jscai.2023.100597

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von Koch, S., Bergman, S., Andell, P., Olivecrona, G. K., Götberg, M., Omerovic, E., Fröbert, O., Buccheri, S., James, S., Koul, S., Mohammad, M. A., & Erlinge, D. (2023). Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR. Journal of the Society for Cardiovascular Angiography and Interventions, 2(3), Article 100597. https://doi.org/10.1016/j.jscai.2023.100597

@article{237d457b6d964238a2f583053ad1b25c,

title = "Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR",

abstract = "Background: Current evidence suggests that use of intracoronary imaging during percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA) reduces mortality. However, there is a scarcity of data on the overall role of intracoronary imaging, particularly in other non-LMCA proximal coronary artery lesions. We aimed to investigate the association of use of intracoronary imaging on outcome in proximal lesions treated with PCI. Methods: The Swedish Coronary Angiography and Angioplasty Registry was used to identify all proximal coronary artery lesions treated with stent implantation between June 11, 2013, and January 16, 2021. Proximal coronary artery lesions (LMCA, proximal left anterior descending artery, left circumflex artery, and right coronary artery) assessed by intracoronary imaging before and/or after stent implantation were matched to control lesions treated based on angiography alone using propensity score matching. The primary end point was target lesion revascularization with PCI, and secondary end points included all-cause mortality and definite stent thrombosis within 3 years. Results: Among the 3623 matched pairs, intracoronary imaging was associated with significantly lower risk of target lesion revascularization, 3.7% vs 4.7%; hazard ratio (HR), 0.77; 95% CI, 0.61-0.97; P = .025, and all-cause mortality, 9.1% vs 12.8%; HR, 0.70; 95% CI, 0.61-0.81; P < .001, with no difference in definite stent thrombosis. Conclusions: The use of intracoronary imaging in proximal coronary artery lesions is associated with lower rates of repeat revascularization and better survival. The results appear to be primarily driven by improved outcome of LMCA lesions. These results reinforce the role of intracoronary imaging in assessing and treating proximal coronary lesions.",

keywords = "intracoronary imaging, intravascular ultrasound, optical coherence tomography, target lesion revascularization",

author = "{von Koch}, Sacharias and Sofia Bergman and Pontus Andell and Olivecrona, {G{\"o}ran K.} and Matthias G{\"o}tberg and Elmir Omerovic and Ole Fr{\"o}bert and Sergio Buccheri and Stefan James and Sasha Koul and Mohammad, {Moman A.} and David Erlinge",

note = "Publisher Copyright: {\textcopyright} 2023 The Authors",

year = "2023",

month = may,

day = "1",

doi = "10.1016/j.jscai.2023.100597",

language = "English",

volume = "2",

journal = "Journal of the Society for Cardiovascular Angiography and Interventions",

issn = "2772-9303",

publisher = "Elsevier B.V.",

number = "3",

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von Koch, S, Bergman, S, Andell, P, Olivecrona, GK, Götberg, M, Omerovic, E, Fröbert, O, Buccheri, S, James, S, Koul, S, Mohammad, MA & Erlinge, D 2023, 'Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR', Journal of the Society for Cardiovascular Angiography and Interventions, vol. 2, no. 3, 100597. https://doi.org/10.1016/j.jscai.2023.100597

Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR. / von Koch, Sacharias; Bergman, Sofia; Andell, Pontus et al.
In: Journal of the Society for Cardiovascular Angiography and Interventions, Vol. 2, No. 3, 100597, 01.05.2023.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaper › Journal article › Research › peer-review

TY - JOUR

T1 - Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR

AU - von Koch, Sacharias

AU - Bergman, Sofia

AU - Andell, Pontus

AU - Olivecrona, Göran K.

AU - Götberg, Matthias

AU - Omerovic, Elmir

AU - Fröbert, Ole

AU - Buccheri, Sergio

AU - James, Stefan

AU - Koul, Sasha

AU - Mohammad, Moman A.

AU - Erlinge, David

PY - 2023/5/1

Y1 - 2023/5/1

N2 - Background: Current evidence suggests that use of intracoronary imaging during percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA) reduces mortality. However, there is a scarcity of data on the overall role of intracoronary imaging, particularly in other non-LMCA proximal coronary artery lesions. We aimed to investigate the association of use of intracoronary imaging on outcome in proximal lesions treated with PCI. Methods: The Swedish Coronary Angiography and Angioplasty Registry was used to identify all proximal coronary artery lesions treated with stent implantation between June 11, 2013, and January 16, 2021. Proximal coronary artery lesions (LMCA, proximal left anterior descending artery, left circumflex artery, and right coronary artery) assessed by intracoronary imaging before and/or after stent implantation were matched to control lesions treated based on angiography alone using propensity score matching. The primary end point was target lesion revascularization with PCI, and secondary end points included all-cause mortality and definite stent thrombosis within 3 years. Results: Among the 3623 matched pairs, intracoronary imaging was associated with significantly lower risk of target lesion revascularization, 3.7% vs 4.7%; hazard ratio (HR), 0.77; 95% CI, 0.61-0.97; P = .025, and all-cause mortality, 9.1% vs 12.8%; HR, 0.70; 95% CI, 0.61-0.81; P < .001, with no difference in definite stent thrombosis. Conclusions: The use of intracoronary imaging in proximal coronary artery lesions is associated with lower rates of repeat revascularization and better survival. The results appear to be primarily driven by improved outcome of LMCA lesions. These results reinforce the role of intracoronary imaging in assessing and treating proximal coronary lesions.

AB - Background: Current evidence suggests that use of intracoronary imaging during percutaneous coronary intervention (PCI) of the left main coronary artery (LMCA) reduces mortality. However, there is a scarcity of data on the overall role of intracoronary imaging, particularly in other non-LMCA proximal coronary artery lesions. We aimed to investigate the association of use of intracoronary imaging on outcome in proximal lesions treated with PCI. Methods: The Swedish Coronary Angiography and Angioplasty Registry was used to identify all proximal coronary artery lesions treated with stent implantation between June 11, 2013, and January 16, 2021. Proximal coronary artery lesions (LMCA, proximal left anterior descending artery, left circumflex artery, and right coronary artery) assessed by intracoronary imaging before and/or after stent implantation were matched to control lesions treated based on angiography alone using propensity score matching. The primary end point was target lesion revascularization with PCI, and secondary end points included all-cause mortality and definite stent thrombosis within 3 years. Results: Among the 3623 matched pairs, intracoronary imaging was associated with significantly lower risk of target lesion revascularization, 3.7% vs 4.7%; hazard ratio (HR), 0.77; 95% CI, 0.61-0.97; P = .025, and all-cause mortality, 9.1% vs 12.8%; HR, 0.70; 95% CI, 0.61-0.81; P < .001, with no difference in definite stent thrombosis. Conclusions: The use of intracoronary imaging in proximal coronary artery lesions is associated with lower rates of repeat revascularization and better survival. The results appear to be primarily driven by improved outcome of LMCA lesions. These results reinforce the role of intracoronary imaging in assessing and treating proximal coronary lesions.

KW - intracoronary imaging

KW - intravascular ultrasound

KW - optical coherence tomography

KW - target lesion revascularization

UR - http://www.scopus.com/inward/record.url?scp=85159306610&partnerID=8YFLogxK

U2 - 10.1016/j.jscai.2023.100597

DO - 10.1016/j.jscai.2023.100597

M3 - Journal article

C2 - 39130700

AN - SCOPUS:85159306610

SN - 2772-9303

VL - 2

JO - Journal of the Society for Cardiovascular Angiography and Interventions

JF - Journal of the Society for Cardiovascular Angiography and Interventions

IS - 3

M1 - 100597

ER -

Intracoronary Imaging of Proximal Coronary Artery Lesions – A Nationwide Lesion-Level Analysis From SCAAR

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