Improved 3-Year Cardiac Survival After IVUS–Guided Long DES Implantation

Hong, Sung‐Jin; Zhang, Junjie; Mintz, Gary S.; Ahn, Chul‐Min; Kim, Jung-Sun; Kim, Byeong Keuk; Ko, Young Guk; Choi, Donghoon; Jang, Yangsoo; Kan, Jing; Pan, Tao; Gao, Xiaofei; Ge, Zhen; Chen, Shao‐Liang; Hong, Myeong‐Ki

doi:10.1016/j.jcin.2021.10.020

Cited by 41 publications

(32 citation statements)

References 14 publications

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“…After screening through 87 articles, finally, a total of four RCTs and one observational study with 3,349 participants were included (1,708 patients in the IVUS guidance group and 1,641 patients in the angiography guidance group) ( 5 , 8 – 10 ).…”

Section: Resultsmentioning

confidence: 99%

“…Previously less meta-analyses have explored the impact of IVUS versus CAG in guiding PCI but mixed with complex lesions ( 11 – 13 ). Recently, with the release of the 3-year clinical outcomes of IVUS-XPL and ULTIMATE trials, whose conclusion was that using IVUS guidance in DES with long de novo lesions improved long-term patient cardiac survival than CAG guidance ( 5 ). Our results also confirm the similar long clinical outcomes of IVUS versus CAG guidance in DES of long de novo lesions.…”

Section: Discussionmentioning

confidence: 99%

“…Although the primary endpoint of cardiac death was lower in the IVUS-optimized PCI group than in the non-optimized group and the difference was not statistically significant. The results may be due to the small number of patients undergoing IVUS-guided DES implantation and the relatively small number of events ( 5 ).…”

Section: Discussionmentioning

confidence: 99%

“…It is not clear whether the IVUSguided PCI strategy can lead to better clinical outcomes in patients undergoing DES implantation for long de novo coronary lesions. Lastly, meta-analyses compared the IVUS-guidance and angiography-guidance during PCI, including complex lesions, such as left main lesions, chronic total occlusions, and bifurcation lesions (3)(4)(5)(6). But there have been no meta-analysis to compare long-term clinical outcomes of IVUS versus angiography-guided PCI within in long de novo coronary lesions.…”

Section: Introductionmentioning

confidence: 99%

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The long-term clinical outcomes of intravascular ultrasound-guided versus angiography-guided coronary drug eluting stent implantation in long de novo coronary lesions: A systematic review and meta-analysis

Wang

Liang²,

Sun³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundNo meta-analysis has been conducted to compare the long-term clinical outcomes of intravascular ultrasound (IVUS)-guided versus angiographic-guided drug-eluting stent implantation in patients with long de novo coronary lesions. We attempted to compare the efficacy and safety of IVUS guidance versus angiography guidance in percutaneous coronary intervention (PCI) for long de novo coronary lesions.Materials and MethodsWe performed a detailed meta-analysis from four randomized controlled trials (RCTs) and one observational study to compare long outcomes of IVUS versus angiography in guiding coronary stent implantation with long de novo coronary lesions defined as coronary stenosis which need stent implantation >28 mm in length. Data were aggregated for the endpoints measure using the fixed-effects model as pooled odds ratio (OR) with 95% confidence intervals. Clinical outcomes included major adverse cardiovascular events (MACE), all revascularization, including target lesion revascularization (TLR) and target vessel revascularization (TVR), all myocardial infarction (MI), all-cause death, and stent thrombosis (ST). Cochrane Library, Embase, PubMed, and Web of Science were searched.ResultsFour RCTs and one observational study were included in our study with 3,349 patients (IVUS guidance = 1,708; Angiography guidance = 1,641). With mean follow-up of 2 years, the incidence of MACE, all myocardial infarction, all revascularization and stent thrombosis were significantly lower in IVUS-guided DES implantation of patients with long de novo coronary lesions than in angiography-guided patients; MACE [OR 0.41; 95% confidence interval (CI), 0.29–0.58; p < 0.00001], all myocardial infarction (OR 0.23; 95% CI, 0.09–0.58; p = 0.002), all revascularization (OR 0.48; 95% CI, 0.36–0.66; p < 0.00001), stent thrombosis (OR 0.32; 95% CI, 0.11–0.89; p = 0.03). There was no significant difference in all-cause mortality between the two groups (OR 0.82; 95% CI, 0.55–1.23; p = 0.34).ConclusionDuring mean follow-up of 2 years, the incidence of MACE, stent thrombosis, all myocardial infarction and revascularization in patients with long de novo coronary lesions under IVUS-guided PCI were significantly lower than angiography-guided PCI, and there were no statistically significant differences in all-cause mortality.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The long-term clinical outcomes of intravascular ultrasound-guided versus angiography-guided coronary drug eluting stent implantation in long de novo coronary lesions: A systematic review and meta-analysis

Wang

Liang²,

Sun³

et al. 2022

Front. Cardiovasc. Med.

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“…An analysis integrating patient-level data from these 2 studies reported a mortality reduction of 50% at 3 years with IVUS guidance; the annual mortality fell to 0.15% when an optimal IVUS-guided result was obtained (Figure 5). 16 In this pooled analysis, there was a remarkable number-needed-to-treat of 81 to prevent 1 cardiac death at 3 years.…”

Section: Ivus Versus Angiographic Guidancementioning

confidence: 89%

Intravascular Imaging for Percutaneous Coronary Intervention Guidance and Optimization: The Evidence for Improved Patient Outcomes

Mintz¹,

Bourantas²,

Chamié³

2022

Journal of the Society for Cardiovascular Angiography & Int

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Clinical risk overlaps both bare metal and drug‐eluting stents

Tehrani

Seto

2022

Cathet Cardio Intervent

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Key Points Similar to the era of bare‐metal stents, there is increased risk of myocardial infraction and target vessel revascularization in the presence of stent overlap when using drug‐eluting stents (DES). This increased risk of events was present regardless of DES generation or polymer delivery system type. These findings highlight the importance of pre‐intervention planning with imaging‐guided percutaneous coronary intervention.

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Improved 3-Year Cardiac Survival After IVUS–Guided Long DES Implantation

Cited by 41 publications

References 14 publications

The long-term clinical outcomes of intravascular ultrasound-guided versus angiography-guided coronary drug eluting stent implantation in long de novo coronary lesions: A systematic review and meta-analysis

The long-term clinical outcomes of intravascular ultrasound-guided versus angiography-guided coronary drug eluting stent implantation in long de novo coronary lesions: A systematic review and meta-analysis

Intravascular Imaging for Percutaneous Coronary Intervention Guidance and Optimization: The Evidence for Improved Patient Outcomes

Clinical risk overlaps both bare metal and drug‐eluting stents

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