Coronary disease & ACSRandomised controlled trial
Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial
- Randomised controlled trial
- two-stage
- multicentre
- 58 centres in China, Italy, Pakistan and the UK
- patients, follow-up providers and assessors masked; catheterisation laboratory staff not masked
Authors' conclusion
In patients with an acute coronary syndrome, intravascular ultrasound-guided implantation of contemporary drug-eluting stents resulted in a lower 1-year rate of the composite outcome of cardiac death, target vessel myocardial infarction, or clinically driven revascularisation compared with angiography guidance alone.
Study context
- Population
- Patients aged ≥18 years presenting with ACS undergoing PCI with contemporary drug-eluting stents3,504 (>99.9%) completed 1-year follow-up
- Participants
- 3,505 patients
- Comparison
- IVUS-guided PCI vs angiography-guided PCI
- intravascular ultrasoundn = 1,753
- angiographyn = 1,752reference
- Primary endpoint
- Target vessel failure:
- Cardiac death
- Target vessel MI
- Clinically driven target vessel revascularisation
- Follow-up
- 1 year after randomisation
Primary result
Target vessel failure · 1 year
Hazard ratio
0.55
95% CI 0.41–0.74
P = 0.0001
Events by treatment group
IVUS vs Angiography
HR 0.55 (95% CI 0.41–0.74); P = 0.0001
As reported in the abstract
Further findings
All-cause death, stent thrombosis
- No significant differences between groups
Original publication
Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial. Lancet. Published 8 April 2024. doi:10.1016/s0140-6736(24)00282-4
Summarised from the published abstract; every number is checked against it