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ORIGINAL RESEARCH article

Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
Volume 11 - 2024 | doi: 10.3389/fcvm.2024.1421025

Comparison of Angiography-Guided vs Intra-Vascular Imaging-Guiding Percutaneous Coronary Intervention of Acute Myocardial Infarction: A Real World Clinical Practice

Provisionally accepted
Ting-yu Lin Ting-yu Lin 1Ying-Ying Chen Ying-Ying Chen 2Li-Wei Chen Li-Wei Chen 3Yu-Lun Cheng Yu-Lun Cheng 4William K. Hau William K. Hau 5Chien-Hung Hsueh Chien-Hung Hsueh 1Wei Chieh Huang Wei Chieh Huang 1*Tse-Min Lu Tse-Min Lu 1*
  • 1 Taipei Veterans General Hospital, Taipei, Taiwan
  • 2 Mackay Memorial Hospital, Taipei, Taipei County, Taiwan
  • 3 Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
  • 4 Taipei Medical University Hospital, Taipei, Taiwan
  • 5 Prince of Wales Hospital, Shatin, Hong Kong Region, China

The final, formatted version of the article will be published soon.

    The role of routine intravascular imaging in percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) has not been established. This retrospective, single-center study evaluated the clinical outcomes of PCI guided by various imaging modalities in AMI patients between 2012 and 2022. The mean follow-up (FU) was 12.9  1.73 months. The imaging modality-intravascular ultrasound (IVUS), optical coherence tomography (OCT), or angiography alone-was chosen at the operator's discretion. The primary endpoint was major adverse cardiac events (MACEs) (cardiovascular [CV] death, myocardial infarction [MI], target vessel revascularization). Of 1,304 PCIs, 47.5% (n=620) were guided by angiography alone, 37.0% (n=483) were IVUS-guided, and 15.4% (n=201) were OCT-guided. PCI guided by intravascular modalities correlated with lower 1-year MI (1.3%, P=0.001) and MACE (5.2%, P=0.036) rates. OCT-guided PCI correlated with lower rates of 1-year CV death (IVUS vs. OCT: 6.2% vs. 1.5%, P=0.016) and 1-year MACE (IVUS vs. OCT: 6.4% vs. 2.5%, P=0.032). Intravascular imaging modalities and diabetes were predictors of better and worse 1-year MACE outcomes, respectively. PCI guided by intravascular imaging modalities correlated with improved 1-year clinical outcomes when compared to angiography-guided alone PCI. OCT-guided PCI in AMI correlated with lower 1-year MACE rates than that associated with IVUS-guided PCI. Intravascular imaging modalities should be recommended for PCI in AMI, with OCT being considered when appropriate.

    Keywords: Acute myocardial infarction (AMI), percutaneous coronary intervention (PCI), optical coherence tomography (OCT), Intravascular Ultrasound (IVUS), Intravascular image, MACE

    Received: 21 Apr 2024; Accepted: 09 Aug 2024.

    Copyright: © 2024 Lin, Chen, Chen, Cheng, Hau, Hsueh, Huang and Lu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence:
    Wei Chieh Huang, Taipei Veterans General Hospital, Taipei, Taiwan
    Tse-Min Lu, Taipei Veterans General Hospital, Taipei, Taiwan

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.