Key result
Each 0.1 increase in the ratio of stent diameter to vessel diameter was associated with a 2.06-fold higher odds of slow flow during IVUS-guided percutaneous coronary intervention for NSTEMI.
Why the study?
Does a modest stent expansion strategy reduce the incidence of slow flow compared to an aggressive stent expansion strategy in NSTEMI patients undergoing IVUS-guided PCI?
Observational (n=150)
No
Does a modest stent expansion strategy reduce the incidence of slow flow compared to an aggressive stent expansion strategy in NSTEMI patients undergoing IVUS-guided PCI?
Odds Ratio: 2.06 (95% CI 1.23–3.46)
p-value: p=0.006
A modest stent expansion strategy, avoiding a high stent-to-vessel diameter ratio, may reduce the incidence of slow flow during IVUS-guided PCI for NSTEMI.
May support modest stent expansion to reduce slow flow in NSTEMI PCI; hypothesis-generating and needs randomized confirmation.
Slow flow is a serious complication in percutaneous coronary intervention (PCI) and is associated with poor clinical outcomes. Our previous study revealed that the ratio of stent diameter to vessel diameter was the determinant of slow flow in intravascular ultrasound (IVUS)-guided PCI to the culprit lesion of ST elevation myocardial infarction (STEMI). The purpose of this study was to verify whether the ratio of stent diameter to vessel diameter is the determinant of slow flow in IVUS-guided PCI to the culprit lesion of non-STEMI (NSTEMI). We included 150 NSTEMI patients and divided into the slow flow group (n = 17) and the non-slow flow group (n = 133). The ratio of stent diameter to vessel diameter was significantly larger in the slow flow group (0.77 ± 0.11) than the non-slow flow group (0.71 ± 0.11) (P = 0.03). Multivariate logistic regression analysis revealed that the ratio of stent diameter to vessel diameter (per 0.1 increase: OR 2.06, 95% CI 1.23-3.46, P = 0.006) was the determinant of slow flow after controlling covariates. In conclusion, the ratio of stent diameter to vessel diameter was the determinant of slow flow in IVUS-guided PCI to the culprit lesion of NSTEMI. Unlike other parameters, the ratio of stent diameter to vessel diameter is the modifiable parameters. We may consider the modest stent expansion strategy rather than the aggressive stent expansion strategy in IVUS-guided PCI to the culprit lesion of NSTEMI.
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Watanabe et al. (2018) conducted an observational in Non-ST Elevation Myocardial Infarction (NSTEMI) (n=150). Ratio of stent diameter to vessel diameter vs. Lower ratio of stent diameter to vessel diameter was evaluated on Slow flow following stent implantation (OR 2.06, 95% CI 1.23-3.46, p=0.006). Each 0.1 increase in the ratio of stent diameter to vessel diameter was associated with a 2.06-fold higher odds of slow flow during IVUS-guided percutaneous coronary intervention for NSTEMI.
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