{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T18:08:48Z","timestamp":1772993328122,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,11,2]],"date-time":"2015-11-02T00:00:00Z","timestamp":1446422400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovascular Therapeutics"],"published-print":{"date-parts":[[2015,12]]},"abstract":"Summary<\/jats:title>Background<\/jats:title>The routine use of vascular imaging including intravascular ultrasound (IVUS<\/jats:styled-content>) and optical coherence tomography (OCT<\/jats:styled-content>) in guiding percutaneous coronary interventions (PCI<\/jats:styled-content>) is still controversial especially when using drug\u2010eluting stents. A meta\u2010analysis of trials using bare metal stents was previously published.<\/jats:p><\/jats:sec>Methods<\/jats:title>We conducted a meta\u2010analysis of available published trials that compared imaging\u2010guided PCI<\/jats:styled-content> and angiography\u2010guided PCI<\/jats:styled-content> in patients undergoing routine PCI<\/jats:styled-content> only. Trials that enrolled patients with acute coronary syndrome were excluded to decrease heterogeneity. We aimed to study both drug\u2010eluting stents (DES<\/jats:styled-content>) as well as bare metal stents (BMS<\/jats:styled-content>). We identified seven randomized controlled trials on IVUS<\/jats:styled-content>\u2010guided bare metal stents. We also identified three randomized controlled trials on IVUS<\/jats:styled-content>\u2010guided drug\u2010eluting stents. To improve the power of the drug\u2010eluting stent data, we identified, and included, nine registries that compared IVUS<\/jats:styled-content>\u2010guided PCI<\/jats:styled-content> to angiography\u2010guided PCI<\/jats:styled-content> in the drug\u2010eluting stent era. Nonrandomized registries that included BMS<\/jats:styled-content> only were excluded as there are multiple previous meta\u2010analyses that studied these patients. Finally, we identified one registry that compared OCT<\/jats:styled-content>\u2010guided PCI<\/jats:styled-content> to angiography\u2010guided PCI<\/jats:styled-content> using either a BMS<\/jats:styled-content> or a DES<\/jats:styled-content>. A total of 14,197 patients were studied overall. The meta\u2010analysis was conducted using a random effect model.<\/jats:p><\/jats:sec>Results<\/jats:title>Imaging guidance was associated with a significantly larger postintervention minimal luminal diameter (SMD<\/jats:styled-content>: 0.289. 95% CI<\/jats:styled-content>: 0.213\u20130.365. P<\/jats:italic>\u00a0<\u00a00.01).<\/jats:p>Imaging\u2010guided stenting was associated with a significant decrease in the major adverse cardiac events (MACE<\/jats:styled-content>) in the DES<\/jats:styled-content> patients (odds ratio: 0.810. 95% CI<\/jats:styled-content>: 0.719\u20130.912. P<\/jats:italic>\u00a0<\u00a00.01) and combined DES<\/jats:styled-content> and BMS<\/jats:styled-content> patients (odds ratio: 0.782. 95% CI<\/jats:styled-content>: 0.686\u20130.890. P<\/jats:italic>\u00a0<\u00a00.01). Imaging guidance was associated with significantly lower events of death from all causes in DES<\/jats:styled-content> patients (odds ratio: 0.654. 95% CI<\/jats:styled-content>: 0.468\u20130.916. P<\/jats:italic>\u00a0<\u00a00.01) and in the combined DES<\/jats:styled-content> and BMS<\/jats:styled-content> patients (odds ratio: 0.727. 95% CI<\/jats:styled-content>: 0.540\u20130.980. P<\/jats:italic>\u00a0<\u00a00.01).<\/jats:p>The risk of myocardial infarction (MI<\/jats:styled-content>) was significantly lower with imaging guidance in both, DES<\/jats:styled-content> patients (odds ratio: 0.551. 95% CI<\/jats:styled-content>: 0.363\u20130.837. P<\/jats:italic>\u00a0<\u00a00.01) and combined DES<\/jats:styled-content> and BMS<\/jats:styled-content> patients (odds ratio: 0.589. 95% CI<\/jats:styled-content>: 0.425\u20130.816. P<\/jats:italic>\u00a0<\u00a00.01). This may, in part, be explained by the significantly lower risk of stent thrombosis in imaging\u2010guided DES<\/jats:styled-content> patients (odds ratio: 0.651. 95% CI<\/jats:styled-content>: 0.499\u20130.850. P<\/jats:italic>\u00a0<\u00a00.01) and combined DES<\/jats:styled-content> and BMS<\/jats:styled-content> patients (odds ratio: 0.665. 95% CI<\/jats:styled-content>: 0.513\u20130.862. P<\/jats:italic>\u00a0<\u00a00.01). Patients who received a DES<\/jats:styled-content> showed no difference between imaging guidance and angiography guidance in repeated target lesion revascularization, while the analysis of BMS<\/jats:styled-content> alone and the DES<\/jats:styled-content> and BMS<\/jats:styled-content> combined showed significant superiority of the imaging\u2010guided PCI<\/jats:styled-content> group.<\/jats:p><\/jats:sec>Conclusion<\/jats:title>Imaging\u2010guided PCI<\/jats:styled-content> significantly lowered the risk of death, MI<\/jats:styled-content>, stent thrombosis, and the combined MACE<\/jats:styled-content> in DES<\/jats:styled-content>\u2010implanted patients and all stented patients (DES<\/jats:styled-content> or BMS<\/jats:styled-content>). However, imaging guidance had no significant effect on repeated target vessel or target lesion revascularization in patients who received DES<\/jats:styled-content>, likely due to the effect of the drug in the stent.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1755-5922.12160","type":"journal-article","created":{"date-parts":[[2015,9,12]],"date-time":"2015-09-12T15:40:55Z","timestamp":1442072455000},"page":"360-366","source":"Crossref","is-referenced-by-count":28,"title":["The Role of Vascular Imaging in Guiding Routine Percutaneous Coronary Interventions: A Meta\u2010Analysis of Bare Metal Stent and Drug\u2010Eluting Stent Trials"],"prefix":"10.1111","volume":"33","author":[{"given":"Said","family":"Alsidawi","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Health and Diseases University of Cincinnati College of Medicine Cincinnati OH 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