{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:11:06Z","timestamp":1760058666610,"version":"build-2065373602"},"reference-count":12,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T00:00:00Z","timestamp":1744848000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Non-ST-segment elevation myocardial infarction (NSTEMI) can be managed by ischemia guide strategies or early invasive strategies. Here, we present the findings of an updated contemporary analysis regarding the use of intracoronary imaging (ICI)-guided PCI versus angiography-guided PCI and in-hospital mortality in patients with NSTEMI in the United States using the NIS database from 2016 to 2021. ICI use increased by nearly threefold between 2016 and 2021, without a significant difference in in-hospital mortality, though interestingly, mortality rates compared with angiography guidance were similar and relatively low. In this study, the use of ICI was associated with lower adjusted odds of in-hospital mortality, cardiogenic shock, and cardiac arrest, but with a longer length of stay and cost of hospitalization.<\/jats:p>","DOI":"10.3390\/jcdd12040161","type":"journal-article","created":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T20:05:56Z","timestamp":1744920356000},"page":"161","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravascular Imaging-Guided Versus Angiography-Guided Percutaneous Coronary Intervention in Patients with Non-ST-Segment Elevation Myocardial Infarction in the United States: Results from Big Data Analysis"],"prefix":"10.3390","volume":"12","author":[{"given":"Chayakrit","family":"Krittanawong","sequence":"first","affiliation":[{"name":"HumanX, Delaware, DE 19958, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8557-9880","authenticated-orcid":false,"given":"Song Peng","family":"Ang","sequence":"additional","affiliation":[{"name":"Division of Internal Medicine, Rutgers Health\/Community Medical Center, New Brunswick, NJ 08901, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil Sagar","family":"Maitra","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Scripps Clinic, La Jolla, CA 92037, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Wang","sequence":"additional","affiliation":[{"name":"Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN 55905, USA"},{"name":"Division of Health Care Policy and Research, Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mahboob","family":"Alam","sequence":"additional","affiliation":[{"name":"The Texas Heart Institute, Baylor College of Medicine, Houston, TX 77030, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hani","family":"Jneid","sequence":"additional","affiliation":[{"name":"John Sealy Distinguished Centennial Chair in Cardiology, Division of Cardiology, University of Texas Medical Branch, Houston, TX 77225, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1888-0793","authenticated-orcid":false,"given":"Samin","family":"Sharma","sequence":"additional","affiliation":[{"name":"Cardiac Catheterization Laboratory of the Cardiovascular Institute, Mount Sinai Hospital, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Rao, S.V., O\u2019Donoghue, M.L., Ruel, M., Rab, T., Tamis-Holland, J.E., Alexander, J.H., Baber, U., Baker, H., Cohen, M.G., and Cruz-Ruiz, M. (2025). 2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI Guideline for the Management of Patients with Acute Coronary Syndromes: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation.","DOI":"10.1161\/CIR.0000000000001309"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/j.ijcard.2022.01.021","article-title":"Intravascular ultrasound-guided vs. coronary angiography-guided percutaneous coronary intervention in patients with acute myocardial infarction: A systematic review and meta-analysis","volume":"353","author":"Groenland","year":"2022","journal-title":"Int. J. Cardiol."},{"key":"ref_3","first-page":"202","article-title":"National Trends, Mortality and Outcomes in Intravascular Imaging-Guided vs. Angiography-Guided Percutaneous Coronary Intervention in the United States","volume":"23","author":"Krittanawong","year":"2024","journal-title":"Crit. Pathw. Cardiol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2","DOI":"10.1007\/s11886-024-02163-x","article-title":"Coronary Intervention Outcomes in Patients with Liver Cirrhosis","volume":"27","author":"Ang","year":"2025","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"745","DOI":"10.1002\/ccd.31389","article-title":"Intravascular Imaging-Guided vs. Angiography-Guided Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction in the United States","volume":"105","author":"Krittanawong","year":"2025","journal-title":"Catheter. Cardiovasc. Interv."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e026500","DOI":"10.1161\/JAHA.122.026500","article-title":"Impact of Intracoronary Imaging-Guided Percutaneous Coronary Intervention on Procedural Outcomes Among Complex Patient Groups","volume":"11","author":"Mohamed","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2431","DOI":"10.1016\/j.jcin.2021.08.021","article-title":"Impact of Intravascular Ultrasound on Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction","volume":"14","author":"Choi","year":"2021","journal-title":"JACC Cardiovasc. Interv."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e023481","DOI":"10.1161\/JAHA.121.023481","article-title":"Role of Intravascular Ultrasound-Guided Percutaneous Coronary Intervention in Optimizing Outcomes in Acute Myocardial Infarction","volume":"11","author":"Kim","year":"2022","journal-title":"J. Am. Heart Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1855","DOI":"10.1016\/S0140-6736(24)00282-4","article-title":"Intravascular ultrasound-guided vs. angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): A two-stage, multicentre, randomised trial","volume":"403","author":"Li","year":"2024","journal-title":"Lancet"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e031111","DOI":"10.1161\/JAHA.123.031111","article-title":"Intravascular Imaging-Guided vs. Angiography-Guided Percutaneous Coronary Intervention: A Systematic Review and Meta-Analysis of Randomized Trials","volume":"13","author":"Sreenivasan","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1161\/CIRCULATIONAHA.124.070729","article-title":"Prognostic Relevance of Type 4a Myocardial Infarction and Periprocedural Myocardial Injury in Patients with Non-ST-Segment-Elevation Myocardial Infarction","volume":"151","author":"Armillotta","year":"2025","journal-title":"Circulation"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1880","DOI":"10.1016\/j.jcin.2020.04.052","article-title":"Long-Term Outcomes of Coronary Stenting with and Without Use of Intravascular Ultrasound","volume":"13","author":"Mentias","year":"2020","journal-title":"JACC Cardiovasc. 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