SynthesisMedicine2026
Intravascular imaging-guided versus coronary angiography-guided percutaneous coronary intervention: Meta-analysis and trial sequential analysis of randomized controlled trials.
Synthesis in Medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
10 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPrevious meta-analyses have extensively compared the outcomes of intravascular imaging-guided versus coronary angiography-guided percutaneous coronary intervention (PCI) in the treatment of coronary artery disease. However, conducting repeated meta-analyses within a short period may increase the probability of type I or type II errors. Therefore, we employed both traditional meta-analysis and trial sequential analysis (TSA) methods to compare the clinical outcomes of intravascular imaging-guided and coronary angiography-guided PCI.
methodsWe searched PubMed, Cochrane Library, Embase, and Web of Science for literature comparing intravascular imaging-guided versus coronary angiography-guided PCI from inception to August 10, 2024. Four researchers, divided into 2 groups, independently extracted the data. The primary outcomes were major adverse cardiovascular events (MACEs) and target lesion failure (TLF). Secondary outcomes included stent thrombosis and all-cause mortality. TSA was used to analyze these outcomes.
resultsA total of 23 randomized controlled trials with 17,766 participants were included. Compared to angiography, intravascular ultrasound has a significant advantage in reducing MACE (risk ratio [RR]: 0.66; 95% confidence interval [CI]: 0.55-0.80) and TLF (RR: 0.64; 95% CI: 0.54-0.75) during follow-up, supported by high certainty of evidence and confirmed by an 80% power TSA, demonstrating a true positive effect. However, no significant differences were observed in reducing stent thrombosis or all-cause mortality. Similarly, compared to angiography, optical coherence tomography shows a significant advantage in reducing MACE beyond 1 year (RR: 0.79; 95% CI: 0.64-0.99), but further exploration is needed, given that only 3 studies were included. In other aspects, including the reduction of stent thrombosis and all-cause mortality, no significant differences were found.
conclusionIntravascular ultrasound showed truly superior efficacy in reducing MACE and TLF compared to angiography. However, additional studies are needed to further assess the effectiveness of optical coherence tomography.
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