Abstract
BackgroundThe role of intravascular ultrasound (IVUS) in percutaneous coronary interventions (PCI) is still controversial despite several previously published meta-analyses. A meta-analysis to evaluate the controversial role of IVUS-guided PCI with bare-metal stenting was performed and a previous published meta-analysis was re-evaluated in order to clarify the discrepancy between results of these studies.MethodsA systematic review was performed by an electronic search of the PubMed, Embase and Web of Knowledge databases and by a manual search of reference lists for randomized controlled trials published until April 2011, with clinical outcomes and, at least, six months of clinical follow-up. A meta-analysis based on the intention to treat was performed with the selected studies.ResultsFive studies and 1,754 patients were included. There were no differences in death (OR = 1.86; 95% CI = 0.88-3.95; p = 0.10), non-fatal myocardial infarction (OR = 0.65; 95% CI = 0.27-1.58; p = 0.35) and major adverse cardiac events (OR = 0.74; 95% CI = 0.49-1.13; p = 0.16). An analysis of the previous published meta-analysis strongly suggested the presence of publication bias.ConclusionsThere is no evidence to recommend routine IVUS-guided PCI with bare-metal stent implantation. This may be explained by the paucity and heterogeneity of the studies published so far.
Highlights
The role of intravascular ultrasound (IVUS) in percutaneous coronary interventions (PCI) is still controversial despite several previously published meta-analyses
This was corroborated by another meta-analysis that suggested an improvement in acute post-interventional results and lower repeat revascularization, angiographic restenosis and major adverse cardiovascular events (MACE) rates, but showed no effect on death or myocardial infarction (MI) during the follow-up period of six to thirty months [13]
Since IVUS clinical benefit is still controversial and conclusions of meta-analyses may be misleading due to methodological issues, we performed a meta-analysis to assess the effect of IVUS in PCI with bare-metal stent implantation on clinically relevant outcomes, assessing the presence of publication bias
Summary
The role of intravascular ultrasound (IVUS) in percutaneous coronary interventions (PCI) is still controversial despite several previously published meta-analyses. A meta-analysis to evaluate the controversial role of IVUS-guided PCI with bare-metal stenting was performed and a previous published meta-analysis was re-evaluated in order to clarify the discrepancy between results of these studies. A few years later, a meta-analysis did not show any reduction in death or myocardial infarction (MI) but revealed reductions in repeat revascularization and angiographic restenosis after a six-month follow-up [12] This was corroborated by another meta-analysis that suggested an improvement in acute post-interventional results (larger minimal luminal diameter) and lower repeat revascularization, angiographic restenosis and MACE rates, but showed no effect on death or MI during the follow-up period of six to thirty months [13]. A critical review of the last published meta-analysis [13] was performed in order to clarify the discrepancy in the results found in this analysis comparing to medical literature
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
