{ "abstract": "Aims\n\nUncertainty persists regarding the comparative efficacy of intravascular ultrasound (IVUS) and optical coherence tomography (OCT) vs. angiography-guided percutaneous coronary intervention (PCI). We synthesized randomized evidence using reconstructed individual participant data (IPD) and compared the two modalities indirectly.Methods and results\n\nMEDLINE and CENTRAL were searched up to 31 March 2026. IPD were reconstructed from published Kaplan-Meier curves. Primary analyses used one-stage stratified Cox models; secondary analyses included random-effects and Bayesian hierarchical models. The primary outcome was major adverse cardiovascular events (MACE). Twenty-three randomized controlled trials enrolling 21 176 patients were included (16 IVUS, N = 15 209; 7 OCT, N = 5967). IVUS-guided PCI reduced MACE [hazard ratio (HR) 0.74; 95% confidence interval (CI) 0.67-0.83; P < 0.001], target-vessel revascularization (TVR; HR 0.70; 0.60-0.82), and stent thrombosis (ST; HR 0.54; 0.37-0.78). OCT-guided PCI reduced MACE (HR 0.75; 0.63-0.91; P = 0.003), cardiac death (HR 0.48; 0.27-0.83), myocardial infarction (HR 0.79; 0.63-0.99), ST (HR 0.40; 0.22-0.74), and TVR (HR 0.74; 0.57-0.97). Bayesian posterior probabilities of benefit exceeded 82% for all IVUS and 94% for all OCT endpoints. Indirect comparison detected no significant between-modality difference. Meta-regression of IVUS trials revealed heterogeneity by geographic region (P < 0.001) and attenuation of benefit over time (β = +0.034/year; P = 0.004); OCT analyses were non-significant.Conclusion\n\nBoth IVUS and OCT reduced MACE, revascularization, and ST compared with angiography-guided PCI. These findings support intravascular imaging as a routine adjunct to PCI in the populations studied.", "abstract_shown": true, "affiliations": [ "Winchester Cardiology and Vascular Medicine, Winchester Medical Center, 1880 Amherst Street, Winchester, VA 22601, USA.", "Keele Cardiovascular Research Group, Centre for Prognosis Research, School of Medicine, David Weatherall Building, Keele University, Staffordshire ST5 5BG, UK.", "DeMatteis Cardiovascular Institute, St. Francis Hospital & Heart Center, 100 Port Washington Boulevard, Roslyn, NY 11576, USA.", "Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY 10029, USA.", "Inova Schar Heart and Vascular, Inova Health System, 3300 Gallows Road, Falls Church, VA 22042, USA.", "King Salman Heart Center, King Fahad Medical City, P.O. Box 13534, Riyadh 11525, Saudi Arabia.", "Department of Internal Medicine, Mercy St. Vincent Medical Center, 2213 Cherry Street, Toledo, OH 43608, USA.", "Department of Cardiology, Tulane University Hospital, 1430 Tulane Avenue, New Orleans, LA 70112, USA.", "East Jefferson Hospital, 4200 Houma Boulevard, Metairie, LA 70006, USA.", "Padra Clinic, 12 Blvrd, Anas Ibn Malik Street, Al Malqa District, Riyadh, Saudi Arabia.", "Brown University Health Cardiovascular Institute, 2 Dudley Street, Suite 360, Providence, RI 02905, USA.", "Division of Cardiology, UCSF Fresno, University of California San Francisco, 155 North Fresno Street, Fresno, CA 93701, USA.", "Heart Health Center, King Saud Medical City, Riyadh First Health Cluster, Sheikh Abdulaziz Bin Abdulrahman Al Saud Street, Al Shumaisi District, P.O. Box 780, Riyadh 12746, Saudi Arabia.", "Heart, Vascular, and Thoracic Institute, Cleveland Clinic Abu Dhabi, 59 Hamouda Bin Ali Al Dhaheri Street, Al Maryah Island, Abu Dhabi, United Arab Emirates.", "Cardiac Center, King Fahd Armed Forces Hospital, Al Kurnaysh Road, Jeddah 23311, Saudi Arabia." ], "article_type": "research article", "arxiv": null, "author_total": 17, "authors": [ { "affs": [ 0 ], "name": "Aref A Bin Abdulhak", "orcid": "0000-0001-9988-8609" }, { "affs": [ 1 ], "name": "Mamas A Mamas" }, { "affs": [ 2 ], "name": "Ziad A Ali", "orcid": "0000-0002-2482-3197" }, { "affs": [ 3 ], "name": "Roxana Mehran", "orcid": "0000-0002-5546-262X" }, { "affs": [ 4 ], "name": "Wayne B Batchelor", "orcid": "0000-0002-3016-1150" }, { "affs": [ 5 ], "name": "Razan Bahurmuz", "orcid": "0009-0006-5501-1382" }, { "affs": [ 6 ], "name": "Ghulam Mujtaba Ghumman" }, { "affs": [ 7, 8 ], "name": "Ala Mohsen", "orcid": "0000-0002-8403-4296" }, { "affs": [ 9 ], "name": "Khawlah A Hadi", "orcid": "0009-0003-6677-4236" }, { "affs": [ 6 ], "name": "Anas Noman" }, { "affs": [ 10 ], "name": "Marwan Saad" }, { "affs": [ 11 ], "name": "Zaher Fanari" }, { "affs": [ 12 ], "name": "Hazim Rahbi" }, { "affs": [ 13 ], "name": "Musa Sharkawi" }, { "affs": [ 0 ], "name": "Poghni Peri-Okonny", "orcid": "0000-0001-6424-8089" }, { "affs": [ 0 ], "name": "Raveen Chawla" }, { "affs": [ 14 ], "name": "Mirvat Alasnag", "orcid": "0000-0002-8714-0334" } ], "bibtex": "https://research.draconitic.com/paper/4qh6sjvegesvj.bib", "cited_by": 0, "doi": "10.1093/ehjopen/oeag136", "fulltext_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13717910/?tool=EBI", "id": "4qh6sjvegesvj", "issns": [ "2752-4191" ], "landing_url": "https://europepmc.org/article/PMC/PMC13717910", "language": "eng", "licence": "CC-BY", "licence_label": "CC BY", "licence_source": "article", "licence_url": "https://creativecommons.org/licenses/by/4.0/", "metadata_licence": null, "native_subjects": [ [ "heading", "AcademicSubjects/MED00200" ], [ "heading", "Eurheartj/15" ], [ "heading", "Eurheartj/17" ], [ "heading", "Eurheartj/31" ], [ "heading", "Eurheartj/38" ], [ "heading", "Eurheartj/39" ], [ "heading", "Eurheartj/41" ], [ "heading", "Interventional Cardiology and Cardiac Surgery" ], [ "heading", "Original Article" ], [ "openalex", "2746|Coronary Interventions and Diagnostics" ] ], "openalex": "W7212166166", "pdf_url": "https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13717910/pdf/?tool=EBI", "pmcid": "PMC13717910", "pmid": "42959683", "published": "2026-09-01", "publisher": "Oxford University Press", "ris": "https://research.draconitic.com/paper/4qh6sjvegesvj.ris", "sources": [ { "first_seen": "2026-10-31T00:20:39Z", "native_id": "PMC:PMC13717910", "source": "europepmc", "url": "https://europepmc.org/article/PMC/PMC13717910" }, { "first_seen": "2026-11-01T00:20:52Z", "native_id": "MED:42959683", "source": "europepmc", "url": "https://europepmc.org/article/MED/42959683" }, { "first_seen": "2026-11-02T12:22:07Z", "native_id": "PMC13717910", "source": "pmc", "url": "https://doi.org/10.1093/ehjopen/oeag136" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2746|Coronary Interventions and Diagnostics", "subfield": "surgery" } ], "title": "Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention: a reconstructed individual participant data meta-analysis of randomized controlled trials of intravascular ultrasound- and optical coherence tomography-guided strategies", "title_text": "Intravascular imaging-guided versus angiography-guided percutaneous coronary intervention: a reconstructed individual participant data meta-analysis of randomized controlled trials of intravascular ultrasound- and optical coherence tomography-guided strategies", "type": "peer-reviewed", "updated_at": "2026-11-02T12:22:07Z", "url": "https://research.draconitic.com/paper/4qh6sjvegesvj", "venue": "European heart journal open", "versions": [] }