Intravascular Imaging Guidance of PCI Reduces Death, Heart Attack
By Elana Gotkine HealthDay Reporter
MONDAY, Feb. 26, 2024 -- Use of intravascular imaging-guided percutaneous coronary intervention (PCI) with drug-eluting stents results in reduced risks for death, myocardial infarction, repeat revascularization, and stent thrombosis, according to a review published online Feb. 21 in The Lancet.
Gregg W. Stone, M.D., from the Icahn School of Medicine at Mount Sinai in New York City, and colleagues conducted a systematic review to assess the comparative performance of intravascular imaging-guided PCI and angiography-guided PCI with drug-eluting stents. Studies were included that randomly assigned patients undergoing PCI with drug-eluting stents to intravascular ultrasound or optical coherence tomography (OCT) or both, or to angiography alone to guide PCI. Data were obtained from 22 trials, with 15,964 patients who were followed for a weighted mean duration of 24.7 months.
The researchers found that intravascular imaging-guided PCI resulted in a reduced risk for target lesion failure compared with angiography-guided PCI (relative risk, 0.71), which was driven by reduced risks for cardiac death, target vessel-myocardial infarction, and target lesion revascularization (relative risks, 0.55, 0.82, and 0.72, respectively). The risks for stent thrombosis, all myocardial infarction, and all-cause death were also reduced with intravascular imaging guidance (relative risks, 0.52, 0.83, and 0.75, respectively). Similar outcomes were seen for OCT-guided and intravascular ultrasound-guided PCI.
"The routine use of OCT or intravascular ultrasound to guide PCI procedures improves survival and freedom from major adverse events, enhancing both the long-term safety and effectiveness of coronary artery intervention," the authors write.
Several authors disclosed ties to biopharmaceutical companies, including Abbott, which funded the study.
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Posted February 2024
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