Sex Differences in Cardiovascular Outcomes of Intravascular Imaging-Guided Percutaneous Coronary Intervention (PCI): A Meta-Analysis of Randomized Controlled Trials
Pooled result · MACE in menResult — go to the resultRelative risk 0.69 95% CI 0.58–0.81Authors' conclusion
Despite the underrepresentation of women in IVI-guided PCI trials, this meta-analysis demonstrates that IVI-guided PCI confers a comparable reduction in MACE for both men and women, suggesting its potential to mitigate the long-standing sex-specific disparities in coronary intervention outcomes and supports its broader implementation in clinical practice.
Study context
- Population
- Men and women with coronary artery disease (presenting with acute or chronic coronary syndrome) undergoing PCIEight randomized controlled trials, 76.1% men and 23.9% women
- Participants
- 14,812 men
- Comparison
- Intravascular imaging (IVI)-guided vs angiography-guided PCI
- Outcome
- MACE in men
Methodological detailsrandom-effects models
- Random-effects models
Pooled result
As reported in the abstract
Relative risk
0.69
95% CI 0.58–0.81
P < 0.001
IVI-guided PCIvs angiography alone
RR 0.69 (95% CI 0.58–0.81); P < 0.001
Further pooled results
| Outcome | RR (95% CI) | P value | |
|---|---|---|---|
| MACE in women | 0.64 (0.49–0.82) | P < 0.001 | |
| 0.512Relative risk (log scale) |
- Major adverse cardiovascular events (MACE) in women: Pinteraction = 0.62
MACE with intravascular ultrasound-guided PCI, by sex
- Intravascular ultrasound-guided PCI reduced MACE in men and women compared with angiography alone
- Pinteraction = 0.86
MACE with optical coherence tomography-guided PCI, by sex
- Optical coherence tomography-guided PCI reduced MACE in men but not in women compared with angiography alone
- Pinteraction = 0.86
Original publication
Sex Differences in Cardiovascular Outcomes of Intravascular Imaging-Guided PCI: A Meta-Analysis of Randomized Controlled Trials. JACC Adv. Published 18 August 2025. doi:10.
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