CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

Epidemiology and Clinical Outcomes of Patients With Inflammatory Bowel Disease Presenting With Acute Coronary Syndrome Cardiovascular Aging and Heart Failure: JACC Review Topic of the Week From Early Pharmacology to Recent Pharmacology Interventions in Acute Coronary Syndromes Myocardial Infarction Risk Stratification With a Single Measurement of High-Sensitivity Troponin I Morphine and Cardiovascular Outcomes Among Patients With Non-ST-Segment Elevation Acute Coronary Syndromes Undergoing Coronary Angiography Appropriate Use Criteria and Health Status Outcomes Following Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the OPEN-CTO Registry Cardiac Shock Care Centers: JACC Review Topic of the Week Pharmacotherapy in the Management of Anxiety and Pain During Acute Coronary Syndromes and the Risk of Developing Symptoms of Posttraumatic Stress Disorder Relation of prior statin and anti-hypertensive use to severity of disease among patients hospitalized with COVID-19: Findings from the American Heart Association’s COVID-19 Cardiovascular Disease Registry Selection of stenting approach for coronary bifurcation lesions

Review Article2014 Mar;7(3):233-43.

JOURNAL:JACC Cardiovasc Interv. Article Link

Intravascular ultrasound-guided implantation of drug-eluting stents to improve outcome: a meta-analysis

Jang JS, Song YJ, Kang W et al. Keywords: drug-eluting stent(s); intravascular ultrasound; percutaneous coronary intervention

ABSTRACT


OBJECTIVES - The aim of this study was to systematically review and perform a meta-analysis of randomized trials and observational studies of intravascular ultrasound (IVUS)-guided versus angiography-guided implantation of drug-eluting stents (DES).


BACKGROUND - Although studies in the bare-metal stents era suggested that there were clinical benefits to IVUS guidance, it is still controversial whether percutaneous coronary intervention (PCI) with DES guided by IVUS leads to better clinical outcomes.


METHODS - Relevant studies published through March 31, 2013, were searched for and identified in the electronic databases. Summary estimates were obtained using a random-effects model.


RESULTS - From 138 initial citations, 3 randomized trials and 12 observational studies with 24,849 patients (11,793 IVUS-guided and 13,056 angiography-guided) were included in this study. Comparison of IVUS- versus angiography-guided PCI disclosed odds ratios (ORs) for major adverse cardiac events of 0.79 (95% confidence interval [CI]: 0.69 to 0.91; p = 0.001). IVUS-guided PCI was also associated with significantly lower rates of all-cause mortality (OR: 0.64; 95% CI: 0.51 to 0.81; p < 0.001), myocardial infarction (OR: 0.57; 95% CI: 0.42 to 0.78; p < 0.001), target vessel revascularization (OR: 0.81; 95% CI: 0.68 to 0.95; p = 0.01), and stent thrombosis (OR: 0.59; 95% CI: 0.42 to 0.82; p = 0.002). A meta-analysis of propensity-matched studies demonstrated similar results in terms of clinical outcomes, but not repeat revascularization.


CONCLUSIONS - IVUS-guided DES implantation is associated with significantly lower rates of adverse clinical events compared with angiography guidance. Further study is needed to clarify which subgroups of subjects with IVUS guidance will have greater benefit.



Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.