Coronary disease & ACSCohort study
Intravascular imaging-guided percutaneous coronary intervention in patients with acute coronary syndrome
- retrospective observational study
- nationwide database in Japan
- inverse probability of treatment weighting
Authors' conclusion
In real-world clinical practice, the rates of both OCT- and IVUS-guided PCI have increased and have been associated with a lower risk of ACS recurrence compared with angiography-guided PCI in patients with ACS.
Study context
- Population
- Patients hospitalised with acute coronary syndrome (ACS) aged ≥20 years who had undergone first-time percutaneous coronary intervention (PCI), National Database in Japan, April 2014 to March 2021angiography-guided PCI 32,044 · optical coherence tomography (OCT)-guided PCI 22,748 · intravascular ultrasound (IVUS)-guided PCI 297,944
- Participants
- 32,044 / 22,748 / 297,944
- Exposure
- imaging-guided PCI and angiography-guided PCI groups
- angiography-guided PCIn = 32,044reference
- OCT-guided PCIn = 22,748
- IVUS-guided PCIn = 297,944
- Outcome
- ACS recurrence
- Follow-up
- 3-year follow-up period
Main finding
As reported in the abstract
Each group vs angiography-guided PCIHazard ratio (95% CI)P value
OCT-guided PCI
0.81(0.71–0.91)
P < 0.001IVUS-guided PCI
0.76(0.71–0.82)
P < 0.001Observational data: associations, not effects.
Further findings
OCT- and IVUS-guided PCI rates during the study period
- OCT-guided PCI rate increased
- from 4.7% to 6.9%
- IVUS-guided PCI rate increased
- from 77.0% to 87.9%
Original publication
Intravascular imaging-guided percutaneous coronary intervention in patients with acute coronary syndrome. EuroIntervention. Published 2 March 2026. doi:10.4244/eij-d-25-01092
Summarised from the published abstract; every number is checked against it