Background. Intravascular ultrasound (IVUS) guided percutaneous coronary intervention (PCI) has potential benefits. This meta-analysis aimed to explore whether IVUS-guided PCI had better short- and long-term prognoses than angiography-guided PCI. Methods. We retrieved studies from PubMed, Embase, and Cochrane Library. Clinical trials including retrospective and randomized controlled trials (RCTs) that compared IVUS-guided PCI with angiography-guided PCI were included. The patients were followed up after operation at 30 days, 1 year, 2 years, and 3 years. The clinical outcomes were target lesion revascularization (TLR), target vessel revascularization (TVR), and MACEs, including stent thrombosis (ST), myocardial infarction (MI), cardiac death, and all-cause death. The study population included patients with MI, coronary bifurcation lesions, short or long lesions, and unprotected left main coronary artery stenosis (ULMCA). The quality of retrospective trials was evaluated using the Newcastle–Ottawa Scale, and the quality of randomized controlled trials was evaluated using the Jadad score. A total of 20 clinical trials met the criteria. Three trials were randomized controlled trials, while 17 were retrospective trials. Results. A total of 24,783 patients were included. In observational trials, the OR of MACEs was 0.49 (95% CI: 0.38–0.62) in 30 days, 0.65 (95% CI: 0.58–0.73) in one year, 0.51 (95% CI: 0.36–0.71) in two years, and 0.45 (95% CI: 0.31–0.65) in three years. In patients with long coronary lesions, the OR of MACEs in 1 year was 0.64 (95% CI: 0.28–1.50). In patients with left main artery disease, the OR of MACEs in 3 years was 0.42 (95% CI: 0.26–0.67). Compared with angiography-guided PCI, IVUS-guided PCI was associated with a lower incidence of MACEs during the same following period. Conclusion. Compared with angiography-guided PCI, IVUS-guided PCI has better performance in reducing the occurrence of MACEs.

中文翻译：

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血管内超声与血管造影引导的经皮冠状动脉介入治疗的短期和长期预后：一项涉及 24,783 名患者的荟萃分析

背景。血管内超声 (IVUS) 引导的经皮冠状动脉介入治疗 (PCI) 具有潜在的益处。这项荟萃分析旨在探讨 IVUS 引导的 PCI 是否比血管造影引导的 PCI 具有更好的短期和长期预后。方法. 我们从 PubMed、Embase 和 Cochrane 图书馆检索了研究。纳入临床试验，包括比较 IVUS 引导的 PCI 与血管造影引导的 PCI 的回顾性和随机对照试验 (RCT)。术后随访30天、1年、2年、3年。临床结局为靶病变血运重建（TLR）、靶血管血运重建（TVR）和MACE，包括支架血栓（ST）、心肌梗死（MI）、心源性死亡和全因死亡。研究人群包括心肌梗死、冠状动脉分叉病变、短或长病变以及无保护的左冠状动脉主干狭窄 (ULMCA) 患者。回顾性试验的质量采用纽卡斯尔-渥太华量表评价，随机对照试验的质量采用Jadad评分评价。共有 20 项临床试验符合标准。三项试验为随机对照试验，17项为回顾性试验。结果。共纳入 24,783 名患者。在观察性试验中，30 天内 MACE 的 OR 为 0.49（95% CI：0.38-0.62），一年内为 0.65（95% CI：0.58-0.73），两年内为 0.51（95% CI：0.36-0.71） , 和 0.45 (95% CI: 0.31–0.65) 在三年内。在长冠状动脉病变患者中，1 年内 MACE 的 OR 为 0.64（95% CI：0.28-1.50）。在左主动脉疾病患者中，3 年内 MACE 的 OR 为 0.42（95% CI：0.26-0.67）。与血管造影引导的 PCI 相比，IVUS 引导的 PCI 在随后的同一时期与较低的 MACE 发生率相关。结论。与血管造影引导的 PCI 相比，IVUS 引导的 PCI 在减少 MACE 发生方面具有更好的表现。