Author + information
- Hector M. Garcia,
- Kayode O. Kuku,
- Viana Azizi,
- Gebremedhin Melaku,
- Anh Bui,
- Jorge A. Torres-Borrero,
- Yael Meirovich,
- Aaphtaab Dheendsa,
- Solomon Beyene,
- Salahadin Abubakar,
- Alexandre H. Kajita,
- Michael J. Lipinski and
- Ron Waksman
Background: Comparison of the rates of clinical outcomes between optical coherence tomography (OCT) and angiography/intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) is limited due to the small number of under-powered drug eluting stent (DES) studies that have addressed this subject. Therefore, we performed a meta-analysis to compare clinical outcomes following OCT-guided PCI against angiography and IVUS-guidance strategies.
Methods: We abstracted data from randomized control trials and observational comparative studies focusing on OCT vs. Angiography/IVUS guided PCI outcomes identified following a systematic search in MEDLINE/PubMed, Cochrane CENTRAL, Scientific Meeting Reports (abstracts) and Clinicaltrials.gov (April 2006 and May 2016). This meta-analysis included 2 randomized clinical trials and 3 observational studies, consisting of a total of 2,541 patients including 3 comparisons of OCT-guidance vs Angiography guidance and 2 for the OCT-guidance vs IVUS-guidance cohort. Pooled estimates of outcomes, presented as odds ratios (OR) [95% confidence intervals], were generated with random-effect models.
Results: OCT guidance showed significantly lower rates of cardiac deaths (OR 0.40 [0.18, 0.90] p=0.03) and major adverse cardiac events (OR 0.68 [0.47, 0.98] p=0.04) compared to Angiography-guidance alone, while the other outcomes of myocardial infarction, stent thrombosis and target lesion revascularization did not attain statistical significance. None of the outcomes returned statistically significant in the OCT VS IVUS cohort.
Conclusions: Compared to angiographic guidance, OCT-guided PCI for stent implantation was associated with reduction in adverse events for the composite of cardiac deaths, myocardial infarction and repeat revascularizations. More randomized studies comparing OCT-guidance with Angiography and/or IVUS-guided PCI are required to further validate these findings
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Interventional Cardiology: Stent Failure Analysis by Intravascuar Imaging
Abstract Category: 16. Interventional Cardiology: Angiography and Interventional CT/MR
Presentation Number: 1193-133
- 2017 American College of Cardiology Foundation