Ontology highlight
ABSTRACT: Objective
Previous evidence suggested that intravascular ultrasound (IVUS) guidance could improve outcomes after drug-eluting stents (DES) placement, largely driven by data from observational studies. We, therefore, performed a meta-analysis and trial sequential analysis of randomized controlled trials to overcome this limitation.Results
The retrieval process yielded 7 RCTs with 3,192 patients. Compared to the angiography guidance, IVUS-guided DES implantation was associated with a significant reduction in the major adverse cardiac events (MACE) (OR 0.60, 95% CI 0.46-0.78; P < 0.001), target vessel revascularization (OR 0.60, 95% CI 0.40-0.91; P = 0.02) and target lesion revascularization (OR 0.60, 95% CI 0.42-0.85; P = 0.004). IVUS and conventional angiography guidance showed similar incidence of stent thrombosis (ST) (OR 0.56, 95% CI 0.25-1.23; P = 0.15), cardiac death (OR 0.47, 95% CI 0.19-1.15; P = 0.10) and myocardial infarction (OR 0.85, 95% CI 0.45-1.61; P = 0.62). Trial sequential analysis revealed a definite reduction in MACE with IVUS guidance without solid evidence for ST.Materials and methods
A systematical literature search was performed in the databases of PubMed, the Cochrane Library and ClinicalTrials.gov, complemented with reference screening from relevant articles. Primary endpoints were MACE and ST.Conclusions
IVUS-guided DES implantation is associated with a lower risk of MACE and revascularization without conclusive benefits for ST.
SUBMITTER: Qian C
PROVIDER: S-EPMC5601740 | biostudies-literature | 2017 Aug
REPOSITORIES: biostudies-literature
Qian Cheng C Feng Hong H Cao Jianlei J Zhang Guangyu G Wang Yanggan Y
Oncotarget 20170727 35
<h4>Objective</h4>Previous evidence suggested that intravascular ultrasound (IVUS) guidance could improve outcomes after drug-eluting stents (DES) placement, largely driven by data from observational studies. We, therefore, performed a meta-analysis and trial sequential analysis of randomized controlled trials to overcome this limitation.<h4>Results</h4>The retrieval process yielded 7 RCTs with 3,192 patients. Compared to the angiography guidance, IVUS-guided DES implantation was associated with ...[more]