Coronary disease & ACSMeta-analysis
Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis
- Systematic review and network meta-analysis of randomised trials
- frequentist meta-analysis
Authors' conclusion
Compared with angiography guidance, intravascular imaging guidance of coronary stent implantation with OCT or intravascular ultrasound enhances both the safety and effectiveness of PCI, reducing the risks of death, myocardial infarction, repeat revascularisation, and stent thrombosis.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents
- Participants
- 15,964 patients · 22 trials
- Comparison
- Intravascular imaging vs Angiography
- Outcome
- Target lesion failure:
- Cardiac death
- Target vessel-MI
- Target lesion revascularisation
- Follow-up
- Longest reported
Pooled result
As reported in the abstract
Relative risk
0.71
95% CI 0.63–0.80
P < 0.0001
Intravascular imaging vs Angiography
RR 0.71 (95% CI 0.63–0.80); P < 0.0001
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| Cardiac death, TV-MI, target lesion revascularisation — Intravascular imaging vs Angiography · cardiac death | 0.55 (0.41–0.75) | P = 0.0001 | |
| Cardiac death, TV-MI, target lesion revascularisation — Intravascular imaging vs Angiography · TV-MI | 0.82 (0.68–0.98) | P = 0.030 | |
| Cardiac death, TV-MI, target lesion revascularisation — Intravascular imaging vs Angiography · target lesion revascularisation | 0.72 (0.60–0.86) | P = 0.0002 | |
| Stent thrombosis, all MI, all-cause death — Intravascular imaging vs Angiography · stent thrombosis | 0.52 (0.34–0.81) | P = 0.0036 | |
| Stent thrombosis, all MI, all-cause death — Intravascular imaging vs Angiography · all MI | 0.83 (0.71–0.99) | P = 0.033 | |
| Stent thrombosis, all MI, all-cause death — Intravascular imaging vs Angiography · all-cause death | 0.75 (0.60–0.93) | P = 0.0091 | |
| 0.20.5125Relative risk (log scale) |
Optical coherence tomography (OCT)-guided vs intravascular ultrasound-guided PCI
- Outcomes similar for OCT-guided and intravascular ultrasound-guided PCI
Original publication
Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis. Lancet. Published 21 February 2024. doi:10.1016/s0140-6736(23)02454-6
Summarised from the published abstract; every number is checked against it