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3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation

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Gao, Xiao-Fei, Ge, Zhen, Kong, Xiang-Quan, Kan, Jing, Han, Leng, Lu, Shu, Tian, Nai-Liang, Lin, Song, Lu, Qing-Hua, Wang, Xiao-Yan, Li, Qi-Hua, Liu, Zhi-Zhong, Chen, Yan, Qian, Xue-Song, Wang, Juan, Chai, Da-Yang, Chen, Chong-Hao, Pan, Tao, Ye, Fei, Zhang, Jun-Jie, Chen, Shao-Liang·2021·JACC: Cardiovascular Interventions
DOI 10.1016/j.jcin.2020.10.001
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Abstract

OBJECTIVES: The aim of this study was to explore the difference in target vessel failure (TVF) 3 years after intravascular ultrasound (IVUS) guidance versus angiographic guidance among all comers undergoing second-generation drug-eluting stent (DES) implantation. BACKGROUND: The multicenter randomized ULTIMATE (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in "All-Comers" Coronary Lesions) trial showed a lower incidence of 1-year TVF after IVUS-guided DES implantation among all comers compared with angiographic guidance. However, the 3-year clinical outcomes of the ULTIMATE trial remain unknown. METHODS: A total of 1,448 all comers undergoing DES implantation who were randomly assigned to either IVUS guidance or angiographic guidance in the ULTIMATE trial were followed for 3 years. The primary endpoint was the risk for TVF at 3 years. The safety endpoint was definite or probable stent thrombosis (ST). RESULTS: At 3 years, TVF occurred in 47 patients (6.6%) in the IVUS-guided group and in 76 patients (10.7%) in the angiography-guided group (p = 0.01), driven mainly by the decrease in clinically driven target vessel revascularization (4.5% vs. 6.9%; p = 0.05). The rate of definite or probable ST was 0.1% in the IVUS-guided group and 1.1% in the angiography-guided group (p = 0.02). Notably, the IVUS-defined optimal procedure was associated with a significant reduction in 3-year TVF relative to that with the suboptimal procedure. CONCLUSIONS: IVUS-guided DES implantation was associated with significantly lower rates of TVF and ST during 3-year follow-up among all comers, particularly those who underwent the IVUS-defined optimal procedure compared with those with angiographic guidance. (Intravascular Ultrasound Guided Drug Eluting Stents Implantation in "All-Comers" Coronary Lesions; NCT02215915).

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Authors
Gao, X.-F., Ge, Z., Kong, X.-Q., Kan, J., Han, L., Lu, S., Tian, N.-L., Lin, S., Lu, Q.-H., Wang, X.-Y., Li, Q.-H., Liu, Z.-Z., Chen, Y., Qian, X.-S., Wang, J., Chai, D.-Y., Chen, C.-H., Pan, T., Ye, F., Zhang, J.-J., & Chen, S.-L.
Venue
JACC: Cardiovascular Interventions
Publisher
Elsevier BV
Published
2021-02
Volume
14
Issue
3
Pages
247-257
ISSN
  • 1876-7605 (ISSN-L)
  • 1936-8798
DOI
10.1016/j.jcin.2020.10.001
OpenAlex
W3093064810
Cited by
338
References
0
FWCI
29.98
Type
journal article
Language
en
Open access
hybrid

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CoChat. (2026). Citation check: 3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation. https://app.cochat.ai/papers/10.1016/j.jcin.2020.10.001
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Gao, X.-F., Ge, Z., Kong, X.-Q., Kan, J., Han, L., Lu, S., Tian, N.-L., Lin, S., Lu, Q.-H., Wang, X.-Y., Li, Q.-H., Liu, Z.-Z., Chen, Y., Qian, X.-S., Wang, J., Chai, D.-Y., Chen, C.-H., Pan, T., Ye, F., . . . Chen, S.-L. (2021). 3-Year Outcomes of the ULTIMATE Trial Comparing Intravascular Ultrasound Versus Angiography-Guided Drug-Eluting Stent Implantation. JACC: Cardiovascular Interventions. https://doi.org/10.1016/j.jcin.2020.10.001

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