IMPORTANCE: Use of @entity5642 ( @entity5642 ) promotes better clinical outcomes for coronary intervention in complex coronary lesions. However, randomized data demonstrating the clinical usefulness of @entity5642 are limited for lesions treated with drug-eluting stents. OBJECTIVE: To determine whether the long-term clinical outcomes with @entity5642 -guided drug-eluting stent implantation are superior to those with angiography-guided implantation in @entity1 with long coronary lesions. DESIGN, SETTING, AND @entity1 : The Impact of Intravascular Ultrasound Guidance on Outcomes of Xience Prime Stents in Long Lesions ( @entity5642 -XPL) randomized, multicenter trial was conducted in 1400 @entity1 with long coronary lesions (implanted stent >= 28 mm in length) between October 2010 and July 2014 at 20 centers in Korea. INTERVENTIONS: @entity1 were randomly assigned to receive @entity5642 -guided (n   =   700) or angiography-guided (n   =   700) @entity2239 -eluting stent implantation. MAIN OUTCOMES AND MEASURES: Primary outcome measure was the composite of major adverse @entity299 , including @entity204 , @entity75 -related @entity583 , or @entity63 -driven @entity75 revascularization at 1 year, analyzed by intention-to-treat. RESULTS: One-year follow-up was complete in 1323 @entity1 (94.5%). Major adverse @entity299 at 1 year occurred in 19 @entity1 (2.9%) undergoing @entity5642 -guided and in 39 @entity1 (5.8%) undergoing angiography-guided stent implantation (absolute difference, -2.97% [95% CI, -5.14% to -0.79%]) (hazard ratio [HR], 0.48 [95% CI, 0.28 to 0.83], P   =   .007). The difference was driven by a lower risk of @entity63 -driven @entity75 revascularization in @entity1 undergoing @entity5642 -guided (17 [2.5%]) compared with angiography-guided (33 [5.0%]) stent implantation (HR, 0.51 [95% CI, 0.28 to 0.91], P   =   .02). @entity204 and @entity75 -related @entity583 were not significantly different between the 2 groups. For @entity204 , there were 3 @entity1 (0.4%) in the @entity5642 -guided group and 5 @entity1 (0.7%) in the angiography-guided group (HR, 0.60 [95% CI, 0.14 to 2.52], P   =   .48). @entity75 -related @entity583 occurred in 1 @entity1 (0.1%) in the angiography-guided stent implantation group (P   =   .32). CONCLUSIONS AND RELEVANCE: Among @entity1 requiring long coronary stent implantation, the use of @entity5642 -guided @entity2239 -eluting stent implantation, compared with angiography-guided stent implantation, resulted in a significantly lower rate of the composite of major adverse @entity299 at 1 year. These differences were primarily due to lower risk of @entity75 revascularization. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01308281.

Effect of Intravascular Ultrasound-Guided vs Angiography-Guided @entity2239 -Eluting Stent Implantation: The XXXX -XPL Randomized Clinical Trial.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients', 'patient', 'PARTICIPANTS'] @entity63 :: ('MESH:D007511', 'Disease') :: ['ischemia'] @entity75 :: ('MESH:D001927', 'Disease') :: ['Target lesion', 'target lesion'] @entity2239 :: ('MESH:C107135', 'Chemical') :: ['everolimus'] @entity5642 :: ('MESH:D004211', 'Disease') :: ['IVUS', 'intravascular ultrasound'] @entity299 :: ('MESH:D006331', 'Disease') :: ['cardiac events'] @entity583 :: ('MESH:D009203', 'Disease') :: ['myocardial infarction'] @entity204 :: ('MESH:D003643', 'Disease') :: ['Cardiac death', 'cardiac death']
@entity5642 :: (MESH:D004211,Disease) :: ['IVUS']
