Intravascular Ultrasound-Guided versus Angiography-Guided Percutaneous Coronary Intervention for Stent Thrombosis Elevation Myocardial Infarction: An Updated Systematic Review and Meta-Analysis.

IF 1.9 4区 医学 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS
Cardiology Pub Date : 2024-01-01 Epub Date: 2024-02-13 DOI:10.1159/000537682
Jasmeet Kalsi, John M Suffredini, Stephanie Koh, Jing Liu, Mirza U Khalid, Ali Denktas, Mahboob Alam, Waleed Kayani, Xiaoming Jia
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引用次数: 0

Abstract

Introduction: Intravascular ultrasound (IVUS) provides intra-procedural guidance in optimizing percutaneous coronary interventions (PCI) and has been shown to improve clinical outcomes in stent implantation. However, current data on the benefit of IVUS during PCI in ST-elevation myocardial infarction (STEMI) patients is mixed. We performed meta-analysis pooling available data assessing IVUS-guided versus angiography-guided PCI in STEMI patients.

Methods: We conducted a systematic search on PubMed and Embase for studies comparing IVUS versus angiography-guided PCI in STEMI. Mantel-Haenszel random effects model was used to calculate risk ratios (RRs) with 95% confidence intervals (CIs) for outcomes of major adverse cardiovascular events (MACEs), death, myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST) and in-hospital mortality.

Results: A total of 8 studies including 336,649 individuals presenting with STEMI were included for the meta-analysis. Follow-up ranged from 11 to 60 months. We found significant association between IVUS-guided PCI with lower risk for MACE (RR 0.82, 95% CI 0.76-0.90) compared with angiography-guided PCI. We also found significant association between IVUS-guided PCI with lower risk for death, MI, TVR, and in-hospital mortality but not ST.

Conclusion: In our meta-analysis, IVUS-guided compared with angiography-guided PCI was associated with improved long-term and short-term clinical outcomes in STEMI patients.

血管内超声引导与血管造影引导经皮冠状动脉介入治疗ST段抬高心肌梗死:最新的系统回顾和 Meta 分析。
简介血管内超声(IVUS)可为优化经皮冠状动脉介入治疗(PCI)提供术中指导,并可改善支架植入的临床效果。然而,目前关于 STEVI(STEMI)患者在 PCI 过程中使用 IVUS 的益处的数据不一。我们对现有数据进行了荟萃分析,评估了 STEMI 患者在 IVUS 引导下进行 PCI 与在血管造影引导下进行 PCI 的差异:我们在 PubMed 和 Embase 上对 STEMI 患者在 IVUS 与血管造影引导下行 PCI 的比较研究进行了系统检索。采用Mantel-Haenszel随机效应模型计算主要不良心血管事件(MACE)、死亡、心肌梗死(MI)、靶血管血运重建(TVR)、支架血栓形成(ST)和院内死亡率的风险比(RR)及95%置信区间(CI):荟萃分析共纳入了8项研究,包括336,649名STEMI患者。随访时间从 11 个月到 60 个月不等。我们发现,与血管造影引导下的 PCI 相比,IVUS 引导下的 PCI 与较低的 MACE 风险(RR 0.82,95% CI 0.76-0.90)有明显相关性。我们还发现,IVUS引导的PCI与较低的死亡、心肌梗死、TVR和院内死亡风险有明显关联,但与ST无关:在我们的荟萃分析中,IVUS引导下的PCI与血管造影引导下的PCI相比,可改善STEMI患者的长期和短期临床预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Cardiology
Cardiology 医学-心血管系统
CiteScore
3.40
自引率
5.30%
发文量
56
审稿时长
1.5 months
期刊介绍: ''Cardiology'' features first reports on original clinical, preclinical and fundamental research as well as ''Novel Insights from Clinical Experience'' and topical comprehensive reviews in selected areas of cardiovascular disease. ''Editorial Comments'' provide a critical but positive evaluation of a recent article. Papers not only describe but offer critical appraisals of new developments in non-invasive and invasive diagnostic methods and in pharmacologic, nutritional and mechanical/surgical therapies. Readers are thus kept informed of current strategies in the prevention, recognition and treatment of heart disease. Special sections in a variety of subspecialty areas reinforce the journal''s value as a complete record of recent progress for all cardiologists, internists, cardiac surgeons, clinical physiologists, pharmacologists and professionals in other areas of medicine interested in current activity in cardiovascular diseases.
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