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Role of Intravascular Imaging in Complex Percutaneous Coronary Intervention: A Meta-Analysis of Randomized Controlled Trials.
Singh, Sahib; Jain, Anubhav; Goel, Swecha; Garg, Aakash; Chaudhary, Rahul; Tantry, Udaya S; Gurbel, Paul A.
Afiliación
  • Singh S; Department of Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland. Electronic address: sahib_aries2003@yahoo.co.in.
  • Jain A; Division of Cardiology, Ascension Genesys Hospital, Grand Blanc, Michigan.
  • Goel S; Department of Medicine, Sinai Hospital of Baltimore, Baltimore, Maryland.
  • Garg A; Cardiology Associates of Schenectady, St. Peter's Health Partners, Albany, New York.
  • Chaudhary R; Division of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania.
  • Tantry US; Sinai Center for Thrombosis Research, Sinai Hospital of Baltimore, Baltimore, Maryland.
  • Gurbel PA; Division of Cardiology, Sinai Hospital of Baltimore, Baltimore, Maryland.
Am J Cardiol ; 208: 143-152, 2023 12 01.
Article en En | MEDLINE | ID: mdl-37839171
Intravascular imaging (IVI) during percutaneous coronary intervention (PCI) has been shown to improve clinical outcomes. However, data is limited in complex PCI and the adoption remains low. We aimed to conduct a meta-analysis of all available randomized controlled trials comparing IVI with conventional angiography in patients who underwent complex PCI. The primary outcomes of interest were major adverse cardiovascular events, all-cause death, cardiovascular death, myocardial infarction, stent thrombosis, target lesion revascularization and target vessel revascularization. Random-effects model was used to calculate pooled risk ratios (RRs) and 95% confidence intervals (CIs). A total of 10 randomized controlled trials comprising 6,368 patients with 3,452 in the IVI group and 2,916 in the angiography group were included. The mean duration of follow up was 2 years, mean age was 65 years and 73% of patients were men. As compared with PCI with routine angiography, the IVI-guided PCI group had significantly lower risks of major adverse cardiovascular events (RR 0.65, 95% CI 0.56 to 0.75, p <0.00001), stent thrombosis (RR 0.57, 95% CI 0.36 to 0.92, p = 0.02), cardiovascular deaths (RR 0.46, 95% CI 0.31 to 0.68, p = 0.0001), target lesion revascularization (RR 0.61, 95% CI 0.48 to 0.78, p <0.0001) and target vessel revascularization (RR 0.62, 95% CI 0.48 to 0.80, p = 0.0003). All-cause deaths and MI were similar in the 2 groups. In conclusion, among patients who underwent complex PCI, IVI reduces adverse events, importantly stent thrombosis and repeat revascularizations, compared with angiography alone guided PCI.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Enfermedad de la Arteria Coronaria / Intervención Coronaria Percutánea / Infarto del Miocardio Tipo de estudio: Systematic_reviews Límite: Aged / Female / Humans / Male Idioma: En Revista: Am J Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Trombosis / Enfermedad de la Arteria Coronaria / Intervención Coronaria Percutánea / Infarto del Miocardio Tipo de estudio: Systematic_reviews Límite: Aged / Female / Humans / Male Idioma: En Revista: Am J Cardiol Año: 2023 Tipo del documento: Article Pais de publicación: Estados Unidos