Coronary disease & ACSCohort study
Prognostic Impact of Operator Experience and Intravascular Ultrasound (IVUS) Guidance on Long-Term Clinical Outcomes After Complex Percutaneous Coronary Intervention (PCI)
- Retrospective cohort study
- single-centre registry
Authors' conclusion
PCI by experienced operators and the use of IVUS during complex PCI were independently associated with lower long-term risks of cardiac death or TVMI. The beneficial effects of IVUS were more prominent for less experienced operators.
Study context
- Population
- Patients undergoing PCI with drug-eluting stents for complex lesions, Samsung Medical Center registry
- Participants
- 6,005 patients
- Exposure
- Experienced vs less experienced operators; IVUS guidance vs angiography alone
- Less experiencedn = 2,200reference
- Experiencedn = 3,805
- Outcome
- Cardiac death or target vessel MI (target vessel myocardial infarction (TVMI))
- Follow-up
- Up to 10 years
Main finding
As reported in the abstract
Cardiac death or TVMI
Adjusted hazard ratio (95% CI)P value
Experienced operators vs Less experienced operators
0.779(0.663–0.915)
P = 0.002IVUS vs Angiography aloneless experienced operators; 23.5% vs 11.4% (as printed)
0.477(0.337–0.673)
P < 0.001IVUS vs Angiography aloneexperienced operators; 18.0% vs 13.5% (as printed)
0.747(0.559–0.998)
P = 0.048Observational data: associations, not effects.
Further findings
IVUS use
P < 0.001
Original publication
Prognostic Impact of Operator Experience and IVUS Guidance on Long-Term Clinical Outcomes After Complex PCI. JACC Cardiovasc Interv. Published 24 July 2023. doi:10.1016/j.jcin.2023.04.022
Summarised from the published abstract; every number is checked against it