MedElevator
Войти в исследования Medicine · 2026
Intravascular imaging-guided versus coronary angiography-guided percutaneous coronary intervention: Meta-analysis and trial sequential analysis of randomized controlled trials.
СтатьяМетаанализНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Li Xi, Zhong Da, Yin Zhen, Liu Hua, Xie Wenqing, Liao Zhan, Tian Jian, Kong Lingyu, Chen Kunli, Wang Chenggong
Аннотация
BACKGROUND: Previous 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.
METHODS: We 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.
RESULTS: A 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.
CONCLUSION: Intravascular 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.
METHODS: We 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.
RESULTS: A 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.
CONCLUSION: Intravascular 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.