Optical coherence tomography-guided percutaneous coronary intervention compared to angiography-guided percutaneous coronary intervention for complex lesions.

IF 2.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

World Journal of Cardiology Pub Date : 2025-09-26 DOI:10.4330/wjc.v17.i9.110403

Muhammad Burhan, Humza Saeed, Muhammad Usama, Aamnah Tariq, Saira Shafiq, Sonia Hurjkaliani, Minahil Iqbal, Sufyan Shahid, Salman Khalid, Naeem Khan Tahirkheli

{"title":"Optical coherence tomography-guided percutaneous coronary intervention compared to angiography-guided percutaneous coronary intervention for complex lesions.","authors":"Muhammad Burhan, Humza Saeed, Muhammad Usama, Aamnah Tariq, Saira Shafiq, Sonia Hurjkaliani, Minahil Iqbal, Sufyan Shahid, Salman Khalid, Naeem Khan Tahirkheli","doi":"10.4330/wjc.v17.i9.110403","DOIUrl":null,"url":null,"abstract":"Background: Optical coherence tomography (OCT) offers detailed cross-sectional imaging during percutaneous coronary intervention (PCI), aiding in anatomically complex coronary lesions. Despite its advantages, evidence on the clinical effectiveness of OCT-guided PCI remains limited.Aim: To compare clinical outcomes of OCT-guided vs angiography-guided PCI in patients with complex lesions.Methods: Major databases were systematically searched for randomized controlled trials (RCTs) comparing OCT-guided and angiography-guided PCI in complex lesions. Primary outcomes included major adverse cardiovascular events (MACE) and target vessel failure (TVF); secondary outcomes included mortality, myocardial infarction (MI), and other procedural outcomes. A random-effects model was used to pool risk ratio (RR), with 95%CI. Statistical analysis was conducted in R software (v4.4.1), with significance set at P < 0.05.Results: Five RCTs (5737 patients) showed OCT-guided PCI significantly reduced MACE (RR: 0.63, 95%CI: 0.52-0.77, P < 0.01), TVF (RR: 0.68, 95%CI: 0.56-0.83, P < 0.01), all-cause (RR: 0.58, 95%CI: 0.38-0.87, P < 0.01) and cardiac mortality (RR: 0.43, 95%CI: 0.24-0.76, P < 0.01), target-lesion revascularization (RR: 0.53, 95%CI: 0.33-0.84, P < 0.01), stent thrombosis (RR: 0.52, 95%CI: 0.31-0.86, P = 0.01), and target-vessel MI (RR: 0.64, 95%CI: 0.42-0.97, P = 0.04) vs angiography-guided PCI. Periprocedural MI, any revascularization, target-vessel revascularization, and contrast-associated kidney injury were similar between groups.Conclusion: OCT-guided PCI improves outcomes in complex lesions by reducing MACE, TVF, mortality, stent thrombosis, and target-vessel MI. These findings highlight the need for further large-scale RCTs to confirm its benefits.","PeriodicalId":23800,"journal":{"name":"World Journal of Cardiology","volume":"17 9","pages":"110403"},"PeriodicalIF":2.8000,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476618/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Cardiology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4330/wjc.v17.i9.110403","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Optical coherence tomography (OCT) offers detailed cross-sectional imaging during percutaneous coronary intervention (PCI), aiding in anatomically complex coronary lesions. Despite its advantages, evidence on the clinical effectiveness of OCT-guided PCI remains limited.

Aim: To compare clinical outcomes of OCT-guided vs angiography-guided PCI in patients with complex lesions.

Methods: Major databases were systematically searched for randomized controlled trials (RCTs) comparing OCT-guided and angiography-guided PCI in complex lesions. Primary outcomes included major adverse cardiovascular events (MACE) and target vessel failure (TVF); secondary outcomes included mortality, myocardial infarction (MI), and other procedural outcomes. A random-effects model was used to pool risk ratio (RR), with 95%CI. Statistical analysis was conducted in R software (v4.4.1), with significance set at P < 0.05.

Results: Five RCTs (5737 patients) showed OCT-guided PCI significantly reduced MACE (RR: 0.63, 95%CI: 0.52-0.77, P < 0.01), TVF (RR: 0.68, 95%CI: 0.56-0.83, P < 0.01), all-cause (RR: 0.58, 95%CI: 0.38-0.87, P < 0.01) and cardiac mortality (RR: 0.43, 95%CI: 0.24-0.76, P < 0.01), target-lesion revascularization (RR: 0.53, 95%CI: 0.33-0.84, P < 0.01), stent thrombosis (RR: 0.52, 95%CI: 0.31-0.86, P = 0.01), and target-vessel MI (RR: 0.64, 95%CI: 0.42-0.97, P = 0.04) vs angiography-guided PCI. Periprocedural MI, any revascularization, target-vessel revascularization, and contrast-associated kidney injury were similar between groups.

Conclusion: OCT-guided PCI improves outcomes in complex lesions by reducing MACE, TVF, mortality, stent thrombosis, and target-vessel MI. These findings highlight the need for further large-scale RCTs to confirm its benefits.

查看原文本刊更多论文

光学相干层析引导下经皮冠状动脉介入治疗与血管造影引导下经皮冠状动脉介入治疗复杂病变的比较。

背景：光学相干断层扫描（OCT）在经皮冠状动脉介入治疗（PCI）中提供详细的横断面成像，有助于解剖复杂的冠状动脉病变。尽管有其优势，但oct引导下PCI临床有效性的证据仍然有限。目的：比较ct引导下与血管造影引导下PCI在复杂病变患者中的临床效果。方法：系统检索主要数据库，比较ct引导和血管造影引导下PCI治疗复杂病变的随机对照试验（rct）。主要结局包括主要不良心血管事件（MACE）和靶血管衰竭（TVF）；次要结局包括死亡率、心肌梗死（MI）和其他手术结局。采用随机效应模型汇总风险比（RR）， ci为95%。采用R软件（v4.4.1）进行统计学分析，P < 0.05为显著性。结果：5项rct（5737例）显示oct引导下PCI与血管造影引导下PCI相比显著降低MACE （RR: 0.63, 95%CI: 0.52-0.77, P < 0.01）、TVF （RR: 0.68, 95%CI: 0.56-0.83, P < 0.01）、全因（RR: 0.58, 95%CI: 0.38-0.87, P < 0.01）、心脏死亡率（RR: 0.43, 95%CI: 0.24-0.76, P < 0.01）、靶区血管重建术（RR: 0.53, 95%CI: 0.33-0.84, P < 0.01）、支架血栓形成（RR: 0.52, 95%CI: 0.31-0.86, P = 0.01）、靶血管心肌梗死（RR: 0.64, 95%CI: 0.42-0.97, P = 0.04）。围手术期心肌梗死、任何血运重建术、靶血管重建术和对比剂相关肾损伤在两组之间相似。结论：oct引导下的PCI通过降低MACE、TVF、死亡率、支架血栓形成和靶血管心肌梗死改善了复杂病变的预后。这些发现强调需要进一步的大规模随机对照试验来证实其益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

World Journal of Cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

3.30

自引率

5.30%

发文量