The final analysis included data from the ILUMIEN IV trial, OCTOBER trial and several previously completed studies comparing intravascular imaging-guided PCI and angiography-guided PCI. Adding up all of the included trials, researchers were left to compare 7,038 patients treated with intravascular imaging-guided PCI, including 3,120 who underwent IVUS-guided PCI, 2,826 who underwent OCT-guided PCI and another 1,029 who were randomized to undergo IVUS- or OCT-guided PCI. These patients were compared with 5,390 treated with angiography-guided PCI, and each participant was followed for a period of 6 months to five years.
The primary endpoint of the meta-analysis was target lesion failure, which the authors defined as a composite of cardiac death, target vessel myocardial infarction (MI) or target lesion revascularization. Overall, intravascular imaging-guided PCI helped reduce that composite endpoint by 31%. It also was linked to significant reductions in cardiac death, target vessel MI, target lesion revascularization and stent thrombosis.
“The results of this network meta-analysis emphasize the importance of physicians using intravascular imaging with either OCT or IVUS to optimize stent outcomes and improve the long-term prognosis of their patients,” Gregg Stone, MD, a cardiologist and professor of cardiology with Icahn School of Medicine at Mount Sinai in New York, said in a statement.
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