Optical coherence tomography (OCT) - versus angiography-guided strategy for percutaneous coronary intervention: a meta-analysis of randomized trials

Background Optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI) has been shown to improve procedural outcomes. However, evidence supporting its superiority over angiography-guided PCI in terms of clinical outcomes is still emerging and limited. This study aimed to...

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Veröffentlicht in:BMC cardiovascular disorders Jg. 24; H. 1; S. 262 - 10
Hauptverfasser: Wang, Yanwei, Yang, Xi, Wu, Yutao, Li, Yanqin, Zhou, Yijiang
Format: Journal Article
Sprache:Englisch
Veröffentlicht: London BioMed Central 20.05.2024
BioMed Central Ltd
Springer Nature B.V
BMC
Schlagworte:
Acute coronary syndromes
Aged
Angiography
Angiology
Angioplasty
Bias
Blood Transfusion Medicine
Cardiac Surgery
Cardiology
Care and treatment
Clinical trials
Collaboration
Comparative analysis
Coronary Angiography
Coronary artery disease
Coronary Artery Disease - diagnostic imaging
Coronary Artery Disease - mortality
Coronary Artery Disease - therapy
Coronary heart disease
Coronary Thrombosis - diagnostic imaging
Coronary Thrombosis - etiology
Coronary Vessels - diagnostic imaging
Death
Female
Heart attacks
Heart diseases
Humans
Implants
Internal Medicine
Male
Medical imaging
Medicine
Medicine & Public Health
Meta-analysis
Methods
Middle Aged
Mortality
Myocardial infarction
Optical coherence tomography
Patient outcomes
Percutaneous coronary intervention
Percutaneous Coronary Intervention - adverse effects
Percutaneous Coronary Intervention - instrumentation
Percutaneous Coronary Intervention - mortality
Predictive Value of Tests
Randomized Controlled Trials as Topic
Risk Factors
Sensitivity analysis
Stents
Thrombosis
Tomography
Tomography, Optical Coherence
Treatment Outcome
China
Coronary angiography
Percutaneous coronary intervention
Optical coherence tomography
Coronary artery disease
ISSN:1471-2261, 1471-2261
Online-Zugang:Volltext
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Zusammenfassung:Background Optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI) has been shown to improve procedural outcomes. However, evidence supporting its superiority over angiography-guided PCI in terms of clinical outcomes is still emerging and limited. This study aimed to compare the efficacy and safety of OCT-guided PCI versus angiography‐guided PCI in patients with coronary artery disease (CAD). Methods A systematic search of electronic databases was conducted to identify randomized control trials (RCTs) comparing the clinical outcomes of OCT-guided and angiography‐guided PCI in patients with CAD. Clinical endpoints including all-cause mortality, myocardial infarction (MI), target lesion revascularization (TLR), stent thrombosis and major adverse cardiac events (MACE) were assessed. Results Eleven RCTs, comprising 2,699 patients in the OCT-guided group and 2,968 patients in the angiography-guided group met inclusion criteria. OCT-guided PCI was associated with significantly lower rates of cardiovascular death(RR 0.56; 95%CI: 0.32–0.98; p  = 0.04; I 2  = 0%), stent thrombosis(RR 0.56; 95%CI: 0.33–0.95; p  = 0.03; I 2  = 0%), and MACE (RR 0.79; 95%CI: 0.66–0.95; p  = 0.01; I 2  = 5%). The incidence of all-cause death (RR 0.71; 95%CI: 0.49–1.02; p  = 0.06; I 2  = 0%), myocardial infarction (RR 0.86; 95%CI: 0.67–1.10; p  = 0.22; I 2  = 0%) and TLR (RR 0.98; 95%CI: 0.73–1.33; p  = 0.91; I 2  = 0%) was non-significantly lower in the OCT-guided group. Conclusions Among patients undergoing PCI, OCT-guided PCI was associated with lower incidences of cardiovascular death, stent thrombosis and MACE compared to angiography-guided PCI. Trial registration PROSPERO registration number: CRD42023484342.
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ISSN:1471-2261
1471-2261
DOI:10.1186/s12872-024-03930-y