Optical coherence tomography (OCT) - versus angiography-guided strategy for percutaneous coronary intervention: a meta-analysis of randomized trials.
BMC Cardiovasc Disord
; 24(1): 262, 2024 May 20.
Article
en En
| MEDLINE
| ID: mdl-38769510
ABSTRACT
BACKGROUND:
Optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI) has been shown to improve procedural outcomes. However, evidence supporting its superiority over angiography-guided PCI in terms of clinical outcomes is still emerging and limited. This study aimed to compare the efficacy and safety of OCT-guided PCI versus angiography-guided PCI in patients with coronary artery disease (CAD).METHODS:
A systematic search of electronic databases was conducted to identify randomized control trials (RCTs) comparing the clinical outcomes of OCT-guided and angiography-guided PCI in patients with CAD. Clinical endpoints including all-cause mortality, myocardial infarction (MI), target lesion revascularization (TLR), stent thrombosis and major adverse cardiac events (MACE) were assessed.RESULTS:
Eleven RCTs, comprising 2,699 patients in the OCT-guided group and 2,968 patients in the angiography-guided group met inclusion criteria. OCT-guided PCI was associated with significantly lower rates of cardiovascular death(RR 0.56; 95%CI 0.32-0.98; p = 0.04; I2 = 0%), stent thrombosis(RR 0.56; 95%CI 0.33-0.95; p = 0.03; I2 = 0%), and MACE (RR 0.79; 95%CI 0.66-0.95; p = 0.01; I2 = 5%). The incidence of all-cause death (RR 0.71; 95%CI 0.49-1.02; p = 0.06; I2 = 0%), myocardial infarction (RR 0.86; 95%CI 0.67-1.10; p = 0.22; I2 = 0%) and TLR (RR 0.98; 95%CI 0.73-1.33; p = 0.91; I2 = 0%) was non-significantly lower in the OCT-guided group.CONCLUSIONS:
Among patients undergoing PCI, OCT-guided PCI was associated with lower incidences of cardiovascular death, stent thrombosis and MACE compared to angiography-guided PCI. TRIAL REGISTRATION PROSPERO registration number CRD42023484342.Palabras clave
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Banco de datos:
MEDLINE
Asunto principal:
Enfermedad de la Arteria Coronaria
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Ensayos Clínicos Controlados Aleatorios como Asunto
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Valor Predictivo de las Pruebas
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Angiografía Coronaria
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Tomografía de Coherencia Óptica
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Intervención Coronaria Percutánea
Límite:
Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Año:
2024
Tipo del documento:
Article