Objective To assess the absolute treatment effects of intravascular imaging guided versus angiography guided percutaneous coronary intervention in patients with coronary artery disease, considering their baseline risk.
Design Systematic review and meta-analysis.
Data sources PubMed/Medline, Embase, and Cochrane Library databases up to 31 August 2023.
Study selection Randomized controlled trials comparing intravascular imaging (intravascular ultrasonography or optical coherence tomography) guided versus coronary angiography guided percutaneous coronary intervention in adults with coronary artery disease.
Main outcome measures Random effect meta-analysis and GRADE (grading of recommendations, assessment, development, and evaluation) were used to assess certainty of evidence. Data included rate ratios and absolute risks per 1000 people for cardiac death, myocardial infarction, stent thrombosis, target vessel revascularization, and target lesion revascularization. Absolute risk differe
March 16, 2021
Patients with a history of cocaine use who present with non-ST-segment elevation myocardial infarction have a lower risk of future major adverse cardiovascular events if treated invasively rather than with a more-conservative approach, according to a new retrospective study.
Overall, invasive management, which included coronary angiography followed by PCI or CABG if needed, lowered the risk of MACE at 6 months by 28% compared with a noninvasive strategy.
The results, however, point to one of the major challenges in treating patients with cocaine-associated NSTEMI, namely their ability to adhere to posttreatment dual antiplatelet therapy (DAPT). While there was no greater risk of emergent revascularization in the overall cohort, that risk was significantly elevated among patients deemed nonadherent to medical therapy who’d been treated with a drug-eluting stent, report researchers.