IVUS-Guided vs Angiography-Guided Percutaneous Coronary Intervention (PCI) in Patients With Diabetes With Acute Coronary Syndromes: The IVUS-ACS Trial
Primary result · TVF (Kaplan-Meier rates)Result — go to the resultHazard ratio 0.46 95% CI 0.27–0.81Authors' conclusion
In the large-scale IVUS-ACS trial, IVUS-guided PCI improved 1-year clinical outcomes in high-risk patients with diabetes with ACS.
Study context
- Population
- Patients with diabetes with acute coronary syndromes (ACS)
- Participants
- 1,105 patients
- Comparison
- Intravascular ultrasound (IVUS)-guided PCI vs angiography-guided PCI
- IVUS-guidedn = 554
- Angiography-guidedn = 551reference
- Primary endpoint
- Target vessel failure (TVF) (cardiac death, target vessel MI or clinically driven target vessel revascularization)
- Follow-up
- 1 year
Methodological detailsprespecified stratified subgroup analysis
- Prespecified stratified subgroup analysis
Primary result
TVF (Kaplan-Meier rates)
Hazard ratio
0.46
95% CI 0.27–0.81
P = 0.007
Events by treatment group
IVUS guidance vs Angiographic guidance
HR 0.46 (95% CI 0.27–0.81); P = 0.007
As reported in the abstract
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| TVF without procedural MI · 1 yearIVUS-guided PCI vs Angiographic guidance · 2.0% vs 6.7% | 0.29 (0.15–0.57) | P < 0.001 | |
| All-cause mortality · 1 yearIVUS-guided PCI vs Angiographic guidance | 0.30 (0.10–0.93) | P = 0.037 | |
| 0.10.31310Hazard ratio (log scale) |
Clinically driven TVR · 1 year
- Clinically driven TVR, IVUS vs angiographic guidance: 0.9% vs 3.8%
- P = 0.003
Safety
Stent thrombosis, major bleeding
- No significant differences between the groups
Original publication
IVUS-Guided vs Angiography-Guided PCI in Patients With Diabetes With Acute Coronary Syndromes: The IVUS-ACS Trial. JACC Cardiovasc Interv. Published 28 October 2024. doi:10.
Summarised from the published abstract; every number is checked against it