Mirvat Alasnag: IVUS and OCT Guided PCI Reduce MACE, Revascularization and Stent Thrombosis
Mirvat Alasnag, Editor in Chief of Saudi Medical Journal, Regional Director of Cardiovascular Research Foundation, Member Board Of Trustees, Publication Committee Member, SCAI International Ambassador at Society for Cardiovascular Angiography and Interventions, Interventional Cardiologist at King Fahd Armed Forces Hospital, shared a post on X:
“Our group used reconstructed individual participant data (23 RCTs w 21,176 patients) and compared the two modalities indirectly.
Both IVUS and OCT reduced MACE, revascularization and stent thrombosis compared with angio-guided PCI I would, therefore, recommend imaging as a routine adjunct to PCI in the populations studied…no downgrading ”
Quoting Sripal Bangalore‘s post:
“Based on this analysis, should ACC/AHA guidelines (but not Asian guidelines) downgrade IVI guided PCI from the current Class 1 indication?”
Quoting Salman Arain‘s post:
“More IVUS vs. Angio data—with a twist!
A lot of work went into this meta-analysis.
I’ll confess: the statistics are beyond my pay grade. But the question is fascinating and provocative: Does IVUS-guided PCI perform differently in Asian vs. non-Asian populations?
I know Gregg W. Stone and Sripal Bangalore are working on an updated Lancet meta-analysis. I wonder if they’re accounting for geography?
(And I secretly hope Ibrahim H. Tanboga and David J. Cohen can help me or us parse the statistical methods here. )
Provocative follow-up question: In a ‘mixed’ lab like ours, does IVUS benefit Asian patients more than non-Asian patients?
(My assumption is no, the benefit is equal because IVUS makes me a better operator!)”

Quoting Filippo Crea‘s post:
“A new meta-analysis of trials on IVUS guidance (vs. angiographic guidance) for PCI assesses relative reductions for major adverse cardiac events in trials devided according to geography (Asian or non-Asian).”

Title 1: Intravascular Imaging–Guided Versus Angiography-Guided Percutaneous Coronary Intervention: A Reconstructed Individual Participant Data Meta-Analysis of Randomized Controlled Trials of IVUS- and OCT-Guided Strategies
Authors: Aref A Bin Abdulhak, Mamas A Mamas, Ziad A Ali, Roxana Mehran, Wayne B Batchelor, Razan Bahurmuz, Ghulam Mujtaba Ghumman, Ala Mohsen, Khawlah A Hadi, Anas Noman, Marwan Saad, Zaher Fanari, Hazim Rahbi, Musa Sharkawi, Poghni Peri-Okonny, Raveen Chawla, Mirvat Alasnag
Read the Full Aricle on European Heart Journal Open

Title 2: Geographic heterogeneity in outcomes of intravascular ultrasound-guided vs angiography-guided percutaneous coronary intervention: a meta-analysis of randomized trials
Authors: Heerajnarain Bulluck, Mohammad Haris, Kartik Yadav, Mohamed Abdelgader, Ali Wahab, Alexander Bate, Arka Das
Read the Full Article on European Heart Journal

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