IVUS-guided PCI decreases the risk of in-stent restenosis within 1 year in non-diabetic elderly men

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Previous studies have shown that drug-eluting stents(DES)implantation guided by intravascu-lar ultrasound(IVUS)could significantly decreased the major adverse cardiac events(MACEs),stent thrombosis,and in-stent restenosis.However,it is unclear whether IVUS-guided single-vessel implantation in elderly without diabetes reduces the risk in-stent restenosis within 1 year.The purpose of our study was to determine whether IVUS-guided percutaneous coronary intervention(PCI)reduces the risk of in-stent restenosis within 1 year in el-derly non-diabetic men.Methods 204 elderly non-diabetic males with unstable angina,aged 60-70 years,were taken into our study.All patients underwent coronary angiography(CAG)and left anterior descending branch DES implantation.After that,100 mg aspirin and 75 mg clopidogrel were taken daily.The patients received rou-tine reexamination in the outpatient department,and coronary angiography was performed one year after PCI.102 patients were assigned to PCI+IVUS group(under IVUS guidance)and 102 patients were assigned to PCI group(without IVUS guidance).Two groups were completely matched by age.Multiple logistic analysis and re-ceiver operating characteristic(ROC)curve were conducted to investigate the prevalence rate of in-stent resteno-sis and MACEs.Results In the PCI group,the level of lipoprotein(a)[Lp(a)]and low density lipoprotein cho-lesterol(LDL-C),and the number of smokers were obviously higher than that in the PCI+IVUS group.The in-stent restenosis rate[4(3.92%)vs.13(12.75%),P=0.040]and the risk of in-stent restenosis(OR:0.298,95%CI:0.092-0.969,P=0.040)in the PCI+IVUS group were significantly lower than that in the PCI group.The ROC curve indicated that IVUS was a sensitive and specific factor to decrease the risk of in-stent restenosis[area under the curve(AUC)=0.66,P=0.049].Conclusions IVUS-guided PCI may be an effective method for reducing in-stent restenosis within 1 year in non-diabetic elderly men.
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