C-15 | Effectiveness and Safety of Percutaneous Coronary Intervention with Intravascular Imaging Compared to Angiography Alone

Multiple clinical trials have indicated that intravascular ultrasound (IVUS) guided interventions have superior clinical outcomes compared to angiography alone. This study aims to assess and compare the clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) using IVUS versus angiography. A systematic search of major databases (PubMed Cochrane Embase) was done and 25 studies were deemed related to our topic. We used the Mantel-Haenszel method with a random-effects model with a p value of <0.05 for statistical significance to calculate the pooled risk ratio (RR) using IVUS as the experimental and angiography as the control group. Higgins I2 was used to assess heterogeneity. There was a decreased risk of MACE (RR: 0.77;95% CI = 0.61 - 0.98; p < 0.03), total lesion revascularization (TLR) (RR: 0.62; 95% CI = 0.49 - 0.78; p < 0.00001), and cardiac death (RR: 0.49; 95% CI = 0.28 - 0.86; p = 0.01) in the IVUS group compared to the angiography group. However, no significant difference was noted in all-cause mortality (RR: 1.01; 95% CI = 0.61- 1.65; p = 0.97), total vessel revascularization (TVR) (RR: 0.76; 95% CI=0.53-1.07; p =0.12), Contrast-induced nephropathy (CIN) (RR: 1.25; 95% CI = 0.84- 1.85; p = 0.27), CABG (RR: 1.07; 95% CI = 0.57- 2.00; p = 0.83), stent thrombosis (RR: 1.01; 95% CI = 0.61- 1.65; p = 0.97), total lesion failure (TLF) (RR: 1.18; 95% CI = 0.44- 3.14; p = 0.74) and MI (RR: 0.95; 95% CI = 0.71 - 1.27; p = 0.73) between the two groups Imaging-guided PCI demonstrates a lower risk of MACE, TLR, and cardiac death compared to angiography-guided PCI.