000			02683nam a2200277 4500
001			ESSALUD
005			20260805110532.0
007			ta
008			t pe ||||| |||| 00| 0 spa d
040			_aBMG
041			_aeng
100			_aTesta, Luca _eAutor _953926
245			_aIVUS-Guided versus angiography-Guided PCI in unprotected left main coronary disease
300			_apáginas: 2189-2199
520			_aBackground: Percutaneous coronary intervention (PCI) is increasingly used for revascularization of unprotected left main coronary artery disease. Whether intravascular ultrasonographic (IVUS) guidance during PCI results in better clinical outcomes than conventional angiographic guidance alone is uncertain. Methods: In an international, multicenter, open-label trial, we randomly assigned patients with unprotected left main coronary artery disease in a 1:1 ratio to undergo either IVUS-guided PCI or angiography-guided PCI. The primary end point was a patient-oriented composite of any stroke, any myocardial infarction, any revascularization, or death from any cause at the longest follow-up. Results: A total of 806 patients underwent randomization; 401 were assigned to undergo IVUS-guided PCI and 405 to undergo angiography-guided PCI. The mean (±SD) age of the patients was 71.4±10.7 years, 78.4% of the patients were men, and 34.7% had diabetes. At a median follow-up of 2.9 years, a primary end-point event had occurred in 135 patients (33.7%) in the IVUS-guided PCI group and in 125 patients (30.9%) in the angiography-guided PCI group (hazard ratio, 1.11; 95% confidence interval, 0.87 to 1.42; P=0.40). The incidence of death, myocardial infarction, or revascularization appeared to be similar in the two groups. The percentages of patients with procedure-related and overall safety events also appeared to be similar in the two groups. Conclusions: Among patients with unprotected left main coronary artery disease, IVUS-guided PCI showed no additional benefit over angiography-guided PCI with respect to the incidence of stroke, myocardial infarction, any revascularization, or death from any cause at a median follow-up of 2.9 years.
650			_aCARDIOLOGIA _911301
650			_aENFERMEDAD CORONARIA _914895
650			_aINFARTO DE MIOCARDIO _913202
700			_aDe la Torre Hernández, José María _945497
700			_aDe María, Giovanni Luigi _953927
700			_aJones, Daniel A. _953928
700			_aPiñon-Esteban, Pablo _943128
700			_aCampo, Gianluca _951741
773	0		_022717 _922641 _dMassachusetts NEJM Group _oNEJM008 _tThe New England Journal of Medicine _wESSALUD _x0028-4793
942			_cARTICULOS _e2026-08-03 _zSQB
999			_c22773 _d22773