Abstract 13725: Intravascular Ultrasound-Guided versus Angiography-Guided Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction: A Systematic Review and Meta-Analysis

Abstract

Introduction: Intravascular ultrasound (IVUS) provides intra-procedural guidance in optimizing percutaneous coronary interventions (PCI) and has been shown to improve clinical outcomes in stent implantation. However, current data on the benefit of IVUS during PCI in STEMI patients is mixed. Research Question: Whether IVUS is associated with improved outcomes during PCI in STEMI patients is unclear. Aim: We performed a systematic review and meta-analysis assessing the utility of IVUS during PCI in the setting of STEMI. Methods: We performed a systematic search on PubMed and Embase for studies comparing IVUS versus angiography guided PCI in STEMI. Mantel-Haenszel random effects model was used to calculate risk ratios (RR) with 95% confidence intervals (CI) for outcomes of major cardiovascular adverse events (MACE), death, myocardial infarction (MI), target vessel revascularization (TVR) and stent thrombosis (ST). Analysis was performed using Review Manager version 5.4.1. Results: A total of 7 studies including 78,612 individuals presenting with STEMI were included for the meta-analysis. Follow-up ranged from 11 to 60 months. We found a significant association between IVUS-guided PCI with lower risk for MACE (RR 0.82, 95% CI 0.76-0.90) compared with angiography-guided PCI. We also found significant association between IVUS-guided PCI with lower risk for death, MI, and TVR but not ST (Figure 1). Conclusion: In our meta-analysis, IVUS-guided compared with angiography-guided PCI was associated with improved clinical outcomes in STEMI patients.