Intravascular ultrasound-guided versus coronary angiography-guided percutaneous coronary intervention in patients with acute myocardial infarction: A systematic review and meta-analysis

Intravascular ultrasound (IVUS) can overcome the intrinsic limitations of coronary angiography for lesion assessment and stenting. IVUS improves outcomes of patients presenting with stable or complex coronary artery disease, but dedicated data on the impact of IVUS-guided percutaneous coronary inter...

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Bibliographic Details
Published in:International journal of cardiology 2022-04, Vol.353, p.35-42
Main Authors: Groenland, Frederik T.W., Neleman, Tara, Kakar, Hala, Scoccia, Alessandra, Ziedses des Plantes, Annemieke C., Clephas, Pascal R.D., Chatterjee, Sraman, Zhu, Mahova, den Dekker, Wijnand K., Diletti, Roberto, Zijlstra, Felix, Mahmoud, Karim D., Van Mieghem, Nicolas M., Daemen, Joost
Format: Article
Language:English
Subjects:
Acute myocardial infarction
Coronary angiography
Coronary Angiography - methods
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - etiology
Coronary Artery Disease - surgery
Humans
Intravascular ultrasound
Myocardial Infarction - diagnostic imaging
Myocardial Infarction - etiology
Myocardial Infarction - surgery
Percutaneous coronary intervention
Percutaneous Coronary Intervention - methods
Treatment Outcome
Ultrasonography, Interventional - methods
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Summary:Intravascular ultrasound (IVUS) can overcome the intrinsic limitations of coronary angiography for lesion assessment and stenting. IVUS improves outcomes of patients presenting with stable or complex coronary artery disease, but dedicated data on the impact of IVUS-guided percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI) remains scarce. We systematically searched Embase, MEDLINE, Web of Science Core Collection, Cochrane Central Register of Controlled Trials and Google Scholar for studies that compared clinical outcomes for IVUS- versus angio-guided PCI in patients with AMI. The primary endpoint was all-cause mortality and the secondary endpoint major adverse cardiovascular events (MACE). Mantel-Haenszel random-effects model was used to calculate pooled risk ratios (RR) with 95% confidence intervals (CI). Nine studies (8 observational, 1 RCT) with a total of 838.902 patients (796.953 angio-guided PCI, 41.949 IVUS-guided PCI) were included. In patients with AMI, IVUS-guided PCI was associated with a significantly lower risk of all-cause mortality (pooled RR: 0.70; 95% CI, 0.59–0.82; p 
ISSN:0167-5273
1874-1754
DOI:10.1016/j.ijcard.2022.01.021