Korean Circ J.  2014 May;44(3):148-155. 10.4070/kcj.2014.44.3.148.

Clinical Outcomes in Patients with Intermediate Coronary Stenoses: MINIATURE Investigators (Korea MultIceNter TrIal on Long-Term Clinical Outcome According to the Plaque Burden and Treatment Strategy in Lesions with MinimUm Lumen ARea lEss Than 4 mm2 Using Intravascular Ultrasound)

• Hong YJ
• Choi YH
• Park SY
• Nam CW
• Cho JH
• Kang WY
• Lee SR
• Lee SY
• Kim SW
• Lim SY
• Yun KH
• Kim JS
• Kim JW
• Kang WC
• Kim KS
• Choi JH
• Chung JW
• Kim SJ
• Ahn Y
• Jeong MH

• KMID: 2145475
• DOI: http://doi.org/10.4070/kcj.2014.44.3.148

Abstract

BACKGROUND AND OBJECTIVES
We evaluated the two-year clinical outcomes in patients with angiographically intermediate lesions according to the plaque burden and treatment strategy.
SUBJECTS AND METHODS
We prospectively enrolled patients with angiographically intermediate lesions (diameter stenosis 30-70%) with an intravascular ultrasound (IVUS) minimum lumen area (MLA) <4 mm2 with 50-70% plaque burden of 16 Korean percutaneous coronary intervention centers. Patients were divided into medical therapy group (n=85) and zotarolimus-eluting stent group (ZES; Resolute) group (n=74). We evaluated the incidences of two-year major adverse cardiovascular events (MACE).
RESULTS
A two-year clinical follow-up was completed in 143 patients and MACE occurred in 12 patients. There were no significant differences in the incidences of death (1.3% vs. 3.0%, p=0.471), target vessel-related non-fatal myocardial infarction (0.0% vs. 0.0%, p=1.000) and target vessel revascularizations (7.8% vs. 4.5%, p=0.425) between medical and ZES groups. Independent predictors of two-year MACE included acute myocardial infarction {odds ratio (OR)=2.87; 95% confidence interval (CI) 1.43-6.12, p=0.014}, diabetes mellitus (OR=2.46; 95% CI 1.24-5.56, p=0.028) and non-statin therapy (OR=2.32; 95% CI 1.18-5.24, p=0.034).
CONCLUSION
Medical therapy shows comparable results with ZES, and myocardial infarction, diabetes mellitus and non-statin therapy were associated with the occurrence of two-year MACE in patients with intermediate lesion with IVUS MLA <4 mm2 with 50-70% of plaque burden.

Keyword

Coronary artery disease; Atherosclerotic plaque; Intravascular ultrasonography

MeSH Terms

Constriction, Pathologic
Coronary Artery Disease
Coronary Stenosis*
Diabetes Mellitus
Follow-Up Studies
Humans
Incidence
Myocardial Infarction
Percutaneous Coronary Intervention
Plaque, Atherosclerotic
Prospective Studies
Research Personnel*
Stents
Ultrasonography
Ultrasonography, Interventional

Figure

• 

  Fig. 1 Flow diagram of the patients enrolled in MINIATURE study. CAG: coronary angiography, DS: diameter stenosis, IVUS: intravascular ultrasound, MLA: minimum lumen area, ZES: zotarolimus-eluting stent, MACE: major adverse cardiac event.

• 

  Fig. 2 Coronary angiography (A) and intravascular ultrasound (B) images in distal circumflex artery in a 55-year-old female who presented with unstable angina. EEM: external elastic membrane, CSA: cross-sectional area.

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