Coronary disease & ACSMeta-analysis
Validation of Intravascular Ultrasound–Defined Optimal Stent Expansion Criteria for Favorable 1-Year Clinical Outcomes
- Individual patient data meta-analysis of randomised trials
Authors' conclusion
Post-PCI stent expansion meeting an absolute criterion of MSA >5.5 mm2 was associated with the most favorable clinical outcomes.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI) in 3 RCTs (IVUS-XPL, ULTIMATE, IVUS-ACS)
- Participants
- 6,290 patients · 3 RCTs
- Comparison
- Intravascular ultrasound (IVUS)-optimized PCI vs IVUS-nonoptimized PCI vs angiography-guided PCI
- Angiography-guided PCIn = 3,208reference
- Outcome
- TVF (cardiac death, target vessel MI or target vessel revascularization)
- Follow-up
- 1 year
Pooled result
As reported in the abstract
TVF, absolute criterion MSA >5.5 mm²
Adjusted hazard ratio (95% CI)P value
Optimized PCI vs Nonoptimized PCI
0.45(0.26–0.75)
P = 0.002Optimized PCI vs Angiography-guided PCI
0.35(0.22–0.54)
P < 0.001Further pooled results
| Outcome | Optimized PCI | Nonoptimized PCI | Angiography-guided PCI | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|---|
| Cardiac death or target vessel MI, MSA >5.5 mm² | 0.54% | 1.59% | Not reported in the abstract | 0.39 (0.17–0.91) | P = 0.028 | |
| 0.10.31310Adjusted hazard ratio (log scale) |
Original publication
Validation of Intravascular Ultrasound–Defined Optimal Stent Expansion Criteria for Favorable 1-Year Clinical Outcomes. JACC Cardiovasc Interv. Published 22 September 2025. doi:10.1016/j.jcin.2025.07.024
Summarised from the published abstract; every number is checked against it