{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:25:26Z","timestamp":1776471926142,"version":"3.51.2"},"reference-count":30,"publisher":"Wiley","issue":"S1","license":[{"start":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T00:00:00Z","timestamp":1665964800000},"content-version":"vor","delay-in-days":289,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Optical coherence tomography (OCT) is an adjunct to angiography\u2010guided coronary stent placement. However, in the absence of dedicated, appropriately powered randomized controlled trials, the impact of OCT on clinical outcomes is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To conduct a systematic review and meta\u2010analysis of all available studies comparing OCT\u2010guided versus angiography\u2010guided and intravascular ultrasound (IVUS)\u2010guided coronary stent implantation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>MEDLINE and Cochrane Central were queried from their inception through July 2022 for all studies that sought to compare OCT\u2010guided percutaneous coronary intervention (PCI) to angiography\u2010guided and IVUS\u2010guided PCI. The primary endpoint was minimal stent area (MSA) compared between modalities. Clinical endpoints of interest were all\u2010cause and cardiovascular mortality, major adverse cardiovascular events (MACE), myocardial infarction (MI), target lesion revascularization (TLR), target vessel revascularization (TVR), and stent thrombosis (ST). Risk ratios (RRs) and mean differences (MDs) with their corresponding 95% confidence intervals (CIs) were pooled using a random\u2010effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirteen studies (8 randomized control trials and 5 observational studies) enrolling 6312 participants were included. OCT was associated with a strong trend toward increased MSA compared to angiography (MD\u2009=\u20090.36, <jats:italic>p<\/jats:italic>\u2009=\u20090.06). OCT\u2010guided PCI was also associated with a reduction in the incidence of all\u2010cause mortality [RR\u2009=\u20090.59, 95% CI (0.35, 0.97), <jats:italic>p<\/jats:italic>\u2009=\u20090.04] and cardiovascular mortality [RR\u2009=\u20090.41, 95% CI (0.21, 0.80), <jats:italic>p<\/jats:italic>\u2009=\u20090.009] compared with angiography\u2010guided PCI. Point estimates favored OCT relative to angiography in MACE [RR\u2009=\u20090.75, 95% CI (0.47, 1.20), <jats:italic>p<\/jats:italic>\u2009=\u20090.22] and MI [RR\u2009=\u20090.75, 95% CI (0.53, 1.07), <jats:italic>p<\/jats:italic>\u2009=\u20090.12]. No differences were detected in ST [RR\u2009=\u20090.71, 95% CI (0.21, 2.44), <jats:italic>p<\/jats:italic>\u2009=\u20090.58], TLR [RR\u2009=\u20090.71, 95% CI (0.17, 3.05), <jats:italic>p<\/jats:italic>\u2009=\u20090.65], or TVR rates [RR\u2009=\u20090.89, 95% CI (0.46, 1.73), <jats:italic>p<\/jats:italic>\u2009=\u20090.73]. Compared with IVUS guidance, OCT guidance was associated with a nonsignificant reduction in the MSA (MD\u2009=\u2009\u22120.16, <jats:italic>p<\/jats:italic>\u2009=\u20090.27). The rates of all\u2010cause and cardiovascular mortality, MACE, MI, TLR, TVR, or ST were similar between OCT\u2010guided and IVUS\u2010guided PCI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>OCT\u2010guided PCI was associated with reduced all\u2010cause and cardiovascular mortality compared to angiography\u2010guided PCI. These results should be considered hypothesis generating as the mechanisms for the improved outcomes were unclear as no differences were detected in the rates of TLR, TVR, or ST. OCT\u2010 and IVUS\u2010guided PCI resulted in similar post\u2010PCI outcomes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ccd.30416","type":"journal-article","created":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T15:29:25Z","timestamp":1666020565000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Optical coherence tomography versus angiography and intravascular ultrasound to guide coronary stent implantation: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"100","author":[{"given":"Tariq Jamal","family":"Siddiqi","sequence":"first","affiliation":[{"name":"Department of Medicine University of Mississippi Medical Center Jackson USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1250-6351","authenticated-orcid":false,"given":"Muhammad Shahzeb","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Medical Center Raleigh\u2010Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8352-8369","authenticated-orcid":false,"given":"Keyvan","family":"Karimi Galougahi","sequence":"additional","affiliation":[{"name":"St. Francis Hospital Roslyn New York USA"},{"name":"Department of Medicine, Clinical Trials Center Cardiovascular Research Foundation New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Evan","family":"Shlofmitz","sequence":"additional","affiliation":[{"name":"St. Francis Hospital Roslyn New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey W.","family":"Moses","sequence":"additional","affiliation":[{"name":"St. Francis Hospital Roslyn New York USA"},{"name":"Department of Medicine,\u00a0Division of Cardiology Columbia University Medical Center New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunil","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Cardiology Duke University Medical Center Raleigh\u2010Durham North Carolina USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nick E. 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