CHE Qianqiu 2 , WANG Qiongying 1 , LIANG Yubo 3 , QI Miaomiao 1 , ZHANG Shuwen 4 , ZHANG Jing 4 , XU Jiaojiao 4 , HU Dingyao 4 , LIU Pengchen 4 , DU Yali 4 , BAI Feng 1
  • 1. Department of Cardiology, Lanzhou University Second Hospital, Lanzhou, 730030, P.R.China;
  • 2. Department of Cardiology, Hospital of Chengdu Office of People’s Government of Tibetan Autonomous Region (Hospital.C.T.), Chengdu, 610041, P.R.China;
  • 3. Department of Cardiology, Gansu Provincial Hospital, Lanzhou, 730030, P.R.China;
  • 4. The Second Clinical Medicine College of Lanzhou University, Lanzhou, 730030, P.R.China;
BAI Feng, Email: baifeng@medmail.com.cn
Percutaneous coronary intervention; Intravascular ultrasound; Coronary angiography; Left main; Meta-analysis; Systematic review; Randomized controlled trial; Cohort study
10.7507/1672-2531.201810074
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Objectives To systematically review the efficacy and safety of intravascular ultrasound (IVUS) and coronary angiography-guided percutaneous coronary intervention (PCI) in left main coronary artery disease. Methods PubMed, EMbase, The Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect randomized controlled trials (RCTs) and cohort studies on the efficacy and safety of IVUS and coronary angiography-guided PCI in left main coronary artery disease from inception to March, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies; then, meta-analysis was performed using RevMan 5.3 software.Results A total of 7 studies involving 7 777 patients were included. The results of meta-analysis showed that: compared with PCI guided by coronary angiography, the incidence of cardiac death (OR=0.45, 95%CI 0.34 to 0.61, P<0.000 01), myocardial infarction (OR=0.67, 95%CI 0.53 to 0.84, P=0.004), major adverse cardiovascular events (OR=0.46, 95%CI 0.34 to 0.61, P<0.000 01), total deaths (OR=0.54, 95%CI 0.44 to 0.67, P<0.000 01), and in-stent thrombosis (OR=0.28, 95%CI 0.18 to 0.45, P<0.000 01) occurred in PCI guided by IVUS were lower. The differences were statistically significant. However, there were no statistical significance in the incidence of target revascularization in PCI (OR=0.80, 95%CI 0.40 to 1.61, P=0.54) and revascularization of target lesions (OR=0.68, 95%CI 0.36 to 1.27, P=0.23) between two groups.Conclusions Current evidence shows that the IVUS-guided PCI can decrease the incidence of cardiac death, myocardial infarction, MACEs, stent thrombosis, total death and has no effect on target lesion revascularization and target vessel revascularization. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusion.

Citation： CHE Qianqiu, WANG Qiongying, LIANG Yubo, QI Miaomiao, ZHANG Shuwen, ZHANG Jing, XU Jiaojiao, HU Dingyao, LIU Pengchen, DU Yali, BAI Feng. Efficacy and safety of intravascular ultrasound and coronary angiography in the left main coronary artery disease: a meta-analysis. Chinese Journal of Evidence-Based Medicine, 2020, 20(1): 71-78. doi: 10.7507/1672-2531.201810074 Copy

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