CLINICAL RESEARCH: CARDIAC IMAGING
Long-term safety of intravascular ultrasound in nontransplant, nonintervened, atherosclerotic coronary arteries
Antoine Guédès, MD,
Pierre-Frédéric Keller, MD,
Philippe L. L'Allier, MD,
Jacques Lespérance, MD,
Jean Grégoire, MD and
Jean-Claude Tardif, MD*
Research Center, Montreal Heart Institute, Montreal, Quebec, Canada
Manuscript received September 15, 2004;
revised manuscript received October 25, 2004,
accepted October 26, 2004.
* Reprint requests and correspondence: Dr. Jean-Claude Tardif, MHI Research Center, Montreal Heart Institute, 5000 Belanger Street, Montreal, Quebec, Canada, H1T 1C8 (Email: jean-claude.tardif{at}icm-mhi.org).
OBJECTIVES: The goal of this study was to demonstrate that intravascular ultrasound (IVUS) examination of native coronary arteries does not result in an acceleration of the atherosclerotic process.
BACKGROUND: Intravascular ultrasound is increasingly used to assess the effects of pharmacologic agents on atherosclerosis.
METHODS: Intravascular ultrasound examinations of one coronary artery and coronary angiography were performed in 525 patients at baseline. Patients then underwent a follow-up angiogram 18 to 24 months later. All end points were evaluated in IVUS-related and non-IVUS arteries using quantitative coronary analysis. The study end points were the coronary change score (per-patient mean of minimum lumen diameter changes for all lesions measured), occurrence of new coronary lesions, and progression of preexistent lesions at follow-up. Acute angiographic and clinical complications were also analyzed.
RESULTS: Coronary change score was –0.06 ± 0.23 mm and –0.05 ± 0.21 mm for IVUS-related and non-IVUS arteries, respectively (p = 0.35). The increase in percent diameter stenosis from baseline to follow-up was 0.8 ± 6.7% and 1.2 ± 7.0% in the IVUS-related and non-IVUS arteries (p = 0.29). New lesions occurred in 3.6% and 3.9% of IVUS-related and non-IVUS arteries, respectively (p = 0.84). When all coronary lesions were considered, the incidence of lesion progression was not significantly different between IVUS-related (11.6%) and non-IVUS (9.8%) arteries. Coronary spasm occurred in 1.9% of IVUS procedures, and there was one case of acute occlusion with no long-term sequelae.
CONCLUSIONS: Intravascular ultrasound does not significantly accelerate atherosclerosis in native coronary arteries and can be used safely to assess progression/regression in clinical trials.
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Abbreviations and Acronyms
| | IVUS = intravascular ultrasound | | MLD = minimum lumen diameter | | PCI = percutaneous coronary intervention | | QCA = quantitative coronary analysis |
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