{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T17:04:38Z","timestamp":1790096678168,"version":"4.0.1"},"reference-count":49,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,1,16]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Despite the initial evidence supporting the utility of intravascular imaging to guide percutaneous coronary intervention (PCI), adoption remains low. Recent new trial data have become available. An updated study\u2010level meta\u2010analysis comparing intravascular imaging to angiography to guide PCI was performed. This study aimed to evaluate the clinical outcomes of intravascular imaging\u2013guided PCI compared with angiography\u2010guided PCI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      A random\u2010effects meta\u2010analysis was performed on the basis of the intention\u2010to\u2010treat principle. The primary outcomes were major adverse cardiac events, cardiac death, and all\u2010cause death. Mixed\u2010effects meta\u2010regression was performed to investigate the impact of complex PCI on the primary outcomes. A total of 16 trials with 7814 patients were included. The weighted mean follow\u2010up duration was 28.8\u2009months. Intravascular imaging led to a lower risk of major adverse cardiac events (relative risk [RR], 0.67 [95% CI, 0.55\u20130.82];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), cardiac death (RR, 0.49 [95% CI, 0.34\u20130.71];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001), stent thrombosis (RR, 0.63 [95% CI, 0.40\u20130.99];\n                      <jats:italic>P<\/jats:italic>\n                      =0.046), target\u2010lesion revascularization (RR, 0.67 [95% CI, 0.49\u20130.91];\n                      <jats:italic>P<\/jats:italic>\n                      =0.01), and target\u2010vessel revascularization (RR, 0.60 [95% CI, 0.45\u20130.80];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). In complex lesion subsets, the point estimate for imaging\u2010guided PCI compared with angiography\u2010guided PCI for all\u2010cause death was a RR of 0.75 (95% CI, 0.55\u20131.02;\n                      <jats:italic>P<\/jats:italic>\n                      =0.07).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In patients undergoing PCI, intravascular imaging is associated with reductions in major adverse cardiac events, cardiac death, stent thrombosis, target\u2010lesion revascularization, and target\u2010vessel revascularization. The magnitude of benefit is large and consistent across all included studies. There may also be benefits in all\u2010cause death, particularly in complex lesion subsets. These results support the use of intravascular imaging as standard of care and updates of clinical guidelines.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.123.031111","type":"journal-article","created":{"date-parts":[[2024,1,12]],"date-time":"2024-01-12T06:15:27Z","timestamp":1705040127000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":55,"title":["Intravascular Imaging\u2013Guided Versus Angiography\u2010Guided Percutaneous Coronary Intervention: A Systematic Review and Meta\u2010Analysis of Randomized Trials"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2065-4119","authenticated-orcid":false,"given":"Jayakumar","family":"Sreenivasan","sequence":"first","affiliation":[{"name":"Section of Cardiovascular Medicine Yale University School of Medicine New Haven CT 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