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Subclinical and Device-Detected Atrial Fibrillation: Pondering the Knowledge Gap: A Scientific Statement From the American Heart Association Intravascular ultrasound predictors of angiographic restenosis after sirolimus-eluting stent implantation Long-term outcomes with use of intravascular ultrasound for the treatment of coronary bifurcation lesions Effect of the PCSK9 Inhibitor Evolocumab on Total Cardiovascular Events in Patients With Cardiovascular DiseaseA Prespecified Analysis From the FOURIER Trial Long-Term Outcomes After PCI or CABG for Left Main Coronary Artery Disease According to Lesion Location Differential prognostic impact of treatment strategy among patients with left main versus non-left main bifurcation lesions undergoing percutaneous coronary intervention: results from the COBIS (Coronary Bifurcation Stenting) Registry II Intracoronary stenting without anticoagulation accomplished with intravascular ultrasound guidance Anthracycline-induced cardiotoxicity: A multicenter randomised trial comparing two strategies for guiding prevention with enalapril: The International CardioOncology Society-one trial Role of intravascular ultrasound in patients with acute myocardial infarction undergoing percutaneous coronary intervention Current treatment of significant left main coronary artery disease: A review

Review Article2014 Apr 15;113(8):1338-47

JOURNAL:Am J Cardiol. Article Link

Meta-analysis of outcomes after intravascular ultrasound-guided versus angiography-guided drug-eluting stent implantation in 26,503 patients enrolled in three randomized trials and 14 observational studies

Ahn JM, Kang SJ, Park SJ et al. Keywords: IVUS guided PCI; angiography-guided PCI; DES; outcome

ABSTRACT


There are conflicting data regarding the benefit of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) over angiography-guided PCI. Since the last meta-analysis was published, several new studies have been reported. We performed a comprehensive meta-analysis to evaluate the clinical impact of IVUS-guided PCI with drug-elutingstent compared with conventional angiography-guided PCI. This meta-analysis included 26,503 patients from 3 randomized and 14observationalstudies; 12,499 patients underwent IVUS-guided PCI and 14,004 underwent angiography-guided PCI. Main outcome measures were total mortality, myocardial infarction (MI), stent thrombosis, and target lesion revascularization (TLR). IVUS-guided PCI was significantly associated with more stents, longer stents, and larger stents. Regarding clinical outcomes, IVUS-guided PCI was associated with a significantly lower risk of TLR (odds ratio [OR] 0.81, 95% confidence interval [CI] 0.66 to 1.00, p=0.046). In addition, the risk of death (OR 0.61, 95% CI 0.48 to 0.79, p<0.001), MI (OR 0.57, 95% CI 0.44 to 0.75, p<0.001), and stent thrombosis (OR 0.59, 95% CI 0.47 to 0.75, p<0.001) were also decreased. In conclusion, our meta-analysis demonstrated that IVUS-guided PCI was associated with lower risk of death, MI, TLR, and stent thrombosis after drug-eluting stenti mplantation.