Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities
Background: New randomized trials and modalities in guiding percutaneous coronary intervention (PCI) have become available. Objective: We aimed to compare the clinical outcomes of coronary angiography (CAG), intravascular ultrasound (IVUS), optical coherence tomography (OCT), fractional flow reserve...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/9/10/343 |
| _version_ | 1797440814407745536 |
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| author | Mengjin Hu Jiangshan Tan Yuejin Yang |
| author_facet | Mengjin Hu Jiangshan Tan Yuejin Yang |
| author_sort | Mengjin Hu |
| collection | DOAJ |
| description | Background: New randomized trials and modalities in guiding percutaneous coronary intervention (PCI) have become available. Objective: We aimed to compare the clinical outcomes of coronary angiography (CAG), intravascular ultrasound (IVUS), optical coherence tomography (OCT), fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and optical frequency domain imaging (OFDI)-guided PCI. Methods: A network meta-analysis was performed to compare different PCI guidance modalities. The clinical outcomes included major adverse cardiovascular events (MACE), all-cause death, myocardial infarction (MI), and target vessel/lesion revascularization (TVR/TLR). Odds ratio (OR) and corresponding 95% credible interval (CrI) were calculated. Results: Thirty-six randomized trials, including 19,042 patients, were included. In comparison with CAG, IVUS significantly reduced MACE (OR: 0.71; 95% CrI: 0.57 to 0.86) and TVR/TLR (OR: 0.53; 95% CrI: 0.43 to 0.66). MACE (OR: 1.44; 95% CrI: 1.02 to 2.08) and TVR/TLR (OR: 1.87; 95% CrI: 1.04 to 3.71) were significantly increased in the FFR group, compared with IVUS group. There were no significant differences in MACE or TVR/TLR among the left guidance modality comparisons. Differences in all-cause death or MI were not observed in any comparisons. Conclusions: IVUS could reduce MACE and TVR/TLR, compared with CAG or FFR. Therefore, IVUS may be the optimal modality in guiding PCI. |
| first_indexed | 2024-03-09T12:13:51Z |
| format | Article |
| id | doaj.art-6b84d84f4a024ed28b1da4d4e63a21d6 |
| institution | Directory Open Access Journal |
| issn | 2308-3425 |
| language | English |
| last_indexed | 2024-03-09T12:13:51Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj.art-6b84d84f4a024ed28b1da4d4e63a21d62023-11-30T22:48:50ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252022-10-0191034310.3390/jcdd9100343Comparison of Six Different Percutaneous Coronary Intervention Guidance ModalitiesMengjin Hu0Jiangshan Tan1Yuejin Yang2State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, ChinaState Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100037, ChinaBackground: New randomized trials and modalities in guiding percutaneous coronary intervention (PCI) have become available. Objective: We aimed to compare the clinical outcomes of coronary angiography (CAG), intravascular ultrasound (IVUS), optical coherence tomography (OCT), fractional flow reserve (FFR), instantaneous wave-free ratio (iFR), and optical frequency domain imaging (OFDI)-guided PCI. Methods: A network meta-analysis was performed to compare different PCI guidance modalities. The clinical outcomes included major adverse cardiovascular events (MACE), all-cause death, myocardial infarction (MI), and target vessel/lesion revascularization (TVR/TLR). Odds ratio (OR) and corresponding 95% credible interval (CrI) were calculated. Results: Thirty-six randomized trials, including 19,042 patients, were included. In comparison with CAG, IVUS significantly reduced MACE (OR: 0.71; 95% CrI: 0.57 to 0.86) and TVR/TLR (OR: 0.53; 95% CrI: 0.43 to 0.66). MACE (OR: 1.44; 95% CrI: 1.02 to 2.08) and TVR/TLR (OR: 1.87; 95% CrI: 1.04 to 3.71) were significantly increased in the FFR group, compared with IVUS group. There were no significant differences in MACE or TVR/TLR among the left guidance modality comparisons. Differences in all-cause death or MI were not observed in any comparisons. Conclusions: IVUS could reduce MACE and TVR/TLR, compared with CAG or FFR. Therefore, IVUS may be the optimal modality in guiding PCI.https://www.mdpi.com/2308-3425/9/10/343percutaneous coronary interventioncoronary angiographyintravascular ultrasoundoptical coherence tomographyfractional flow reserve |
| spellingShingle | Mengjin Hu Jiangshan Tan Yuejin Yang Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities Journal of Cardiovascular Development and Disease percutaneous coronary intervention coronary angiography intravascular ultrasound optical coherence tomography fractional flow reserve |
| title | Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities |
| title_full | Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities |
| title_fullStr | Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities |
| title_full_unstemmed | Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities |
| title_short | Comparison of Six Different Percutaneous Coronary Intervention Guidance Modalities |
| title_sort | comparison of six different percutaneous coronary intervention guidance modalities |
| topic | percutaneous coronary intervention coronary angiography intravascular ultrasound optical coherence tomography fractional flow reserve |
| url | https://www.mdpi.com/2308-3425/9/10/343 |
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