{
  "abstract": "Background Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) has been shown to improve outcomes in complex coronary artery disease compared with angiography-guided PCI. However, long-term comparisons between IVUS-guided PCI and coronary artery bypass grafting (CABG) for multivessel disease (MVD) remain limited.Methods This post hoc analysis of the Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment Extended Follow-up study included 880 patients with MVD, excluding 15 patients who received medical therapy. Patients were categorised into IVUS-guided PCI (n=333), angiography-guided PCI (n=131) and CABG (n=401). The primary endpoint was the composite of death, myocardial infarction (MI) or target-vessel revascularisation over a median follow-up of 11.8 years.Results The IVUS-guided PCI group showed no difference in the primary endpoint compared with CABG (adjusted HR 1.013; 95% CI 0.747 to 1.374; p=0.93). In contrast, angiography-guided PCI was associated with a higher risk of clinical events (adjusted HR 2.231; 95% CI 1.582 to 3.145; p<0.001). The safety endpoint (composite of death, MI and stroke) did not differ between IVUS-guided PCI and CABG (adjusted HR 0.845; 95% CI 0.605 to 1.181; p=0.324), while angiography-guided PCI was associated with a higher risk (adjusted HR 2.016; 95% CI 1.405 to 2.895; p<0.001). Both PCI groups had higher rates of repeat revascularisation compared with CABG.Conclusions IVUS-guided PCI demonstrated comparable long-term outcomes to CABG in terms of mortality and safety endpoints, supporting its use in the treatment of MVD. These findings highlight the potential benefits of IVUS guidance in complex PCI procedures.Trial registration numbers NCT05125367 and NCT00997828.",
  "authors": [
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea",
        "Department of Cardiology, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Korea"
      ],
      "name": "Jinho Lee"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea",
        "Department of Cardiology, Sejong General Hospital, Bucheon, Korea"
      ],
      "name": "Jung-Min Ahn"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea",
        "Department of Cardiology, Changwon Hanmaeum Hospital, Changwon, Korea"
      ],
      "name": "Hoyun Kim"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea",
        "Department of Cardiology, Dong-A University Hospital, University of Dong-A College of Medicine, Busan, Korea"
      ],
      "name": "Yeonwoo Choi"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"
      ],
      "name": "Sangyong Jo"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"
      ],
      "name": "Do-Yoon Kang"
    },
    {
      "affiliations": [
        "Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"
      ],
      "name": "Min-Ju Kim"
    },
    {
      "affiliations": [
        "Cardiovascular Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea"
      ],
      "name": "Seung Ho Hur"
    },
    {
      "affiliations": [
        "Department of Cardiology, The Catholic University of Korea, Seoul St. Mary’s Hospital, Seoul, Korea"
      ],
      "name": "Hun-Jun Park"
    },
    {
      "affiliations": [
        "Department of Cardiology, Mahidol University Faculty of Medicine Siriraj Hospital, Bangkok, Thailand"
      ],
      "name": "Damras Tresukosol"
    },
    {
      "affiliations": [
        "Department of Cardiology, Gil Hospital, Gachon University, Incheon, Korea"
      ],
      "name": "Woong Chol Kang"
    },
    {
      "affiliations": [
        "Department of Cardiology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea"
      ],
      "name": "Hyuck Moon Kwon"
    },
    {
      "affiliations": [
        "Cardiovascular Center, Korea University Guro Hospital, Seoul, Korea"
      ],
      "name": "Seung-Woon Rha"
    },
    {
      "affiliations": [
        "Division of Cardiology, Korea University Anam Hospital, Seoul, Korea"
      ],
      "name": "Do-Sun Lim"
    },
    {
      "affiliations": [
        "Division of Cardiology, Chonnam National University Hospital, Gwangju, Korea"
      ],
      "name": "Myung-Ho Jeong"
    },
    {
      "affiliations": [
        "Cardiology, Kangwon National University Hospital, Chuncheon, Korea"
      ],
      "name": "Bong-Ki Lee"
    },
    {
      "affiliations": [
        "Cardiology, Zhejiang University School of Medicine Sir Run Run Shaw Hospital, Hangzhou, Zhejiang, China"
      ],
      "name": "He Huang"
    },
    {
      "affiliations": [
        "Division of Cardiology, Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea"
      ],
      "name": "Young-Hyo Lim"
    },
    {
      "affiliations": [
        "Cardiology, Konyang University Hospital, Daejeon, Korea"
      ],
      "name": "Jang Ho Bae"
    },
    {
      "affiliations": [
        "Cardiovascular Center, Sanggye Paik Hospital, Inje University, Seoul, Korea"
      ],
      "name": "Byung Ok Kim"
    },
    {
      "affiliations": [
        "Cardiology, Sarawak Heart Centre, Kota Samarahan, Sarawak, Malaysia"
      ],
      "name": "Tiong Kiam Ong"
    },
    {
      "affiliations": [
        "Department of Cardiology, Wonju Severence Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea"
      ],
      "name": "Sung Gyun Ahn"
    },
    {
      "affiliations": [
        "Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"
      ],
      "name": "Cheol-Hyun Chung"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"
      ],
      "name": "Duk-Woo Park"
    },
    {
      "affiliations": [
        "Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea"
      ],
      "name": "Seung-Jung Park"
    },
    {
      "affiliations": [],
      "name": "for the BEST Extended Follow-up Study investigators"
    }
  ],
  "title": "Long-term outcomes of intravascular ultrasound-guided percutaneous coronary intervention versus coronary artery bypass grafting for multivessel coronary artery disease",
  "uid": "fc7f18c1-a879-549e-b4f6-56c49caac2bd"
}