Intervascular Imaging Reduces Risk of Adverse Cardiovascular Events Compared With Coronary Angiography

November 20, 2017—A meta-analysis published by Sergio Buccheri, MD, et al in the Journal of the American College of Cardiology (JACC): Cardiovascular Interventions found that the use of intervascular imaging techniques, including intravascular ultrasound (IVUS) and optical coherence tomography (OCT), for percutaneous coronary intervention (PCI) reduces the risk for cardiovascular death and adverse events compared with coronary angiography (CA). The study was published online ahead of print.

Researchers initiated the meta-analysis to identify the comparative clinical efficacy of different imaging modalities for guiding PCI.

As summarized in JACC: Cardiovascular Interventions, the study used comprehensive hierarchical Bayesian network meta-analysis to analyze 31 studies comparing clinical outcomes of PCI with stent implantation guided by CA, IVUS, or OCT. A total of 17,882 patients were included for analysis.

The results showed that compared with CA the risks of all-cause death (odds ratio [OR]: 0.74, 95% credible interval [CI]: 0.58 to 0.98), myocardial infarction (OR: 0.72, 95% CI: 0.52 to 0.93), target lesion revascularization (OR: 0.74, 95% CI: 0.58 to 0.90), and stent thrombosis (OR: 0.42, 95% CI: 0.20 to 0.72) were significantly reduced by IVUS guidance.

The use of IVUS or OCT for PCI guidance was associated with a significant reduction of major adverse cardiovascular events (OR: 0.79, 95% CI: 0.67 to 0.91 and OR: 0.68, 95% CI: 0.49 to 0.97, respectively) and cardiovascular death (OR: 0.47, 95% CI: 0.32 to 0.66 and OR: 0.31, 95% CI: 0.13 to 0.66, respectively).

There were no differences between IVUS and OCT in comparative clinical efficacy in all investigated outcomes, advised the investigators in JACC: Cardiovascular Interventions.