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摘要
Intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) has been reported to significantly reduce major adverse cardiac events (MACEs) compared with angiography-guided PCI. We aimed to explore whether there were racial differences regarding the beneficial effects of IVUS-guided PCI. Randomized controlled trials for comparison of clinical outcomes between IVUS-guided and angiography-guided PCI were retrieved from PubMed, Web of Science, Embase, and the Cochrane Library from incep-tion to March 15, 2023. The clinical outcomes included MACE, all-cause mortality, myo-cardial infarction (MI), target vessel revascularization (TVR), target lesion revascularization (TLR), and stent thrombosis (ST). Finally, 18 randomized controlled tri -als were included in this study (8 in East Asian patients and 10 in Western patients). Results showed that IVUS-guided PCI was associated with a significant reduction of MACE, TVR, TLR, and ST, but not all-cause mortality and MI in both East Asian and Western patients. The reduction of MACE was more significant in East Asian patients (odds ratio [OR] 0.57, 95% confidence interval [CI] 0.46 to 0.70) than that in Western patients (OR 0.83, 95% CI 0.67 to 1.02). Meta-regression analysis revealed that the coun-try the study was performed in (East Asian vs Western countries) was associated with sig-nificant heterogeneity between groups, suggesting that racial differences existed (p = 0.033). In conclusion, IVUS-guided PCI was associated with a lower risk of MACE, TLR, TVR, and ST, but not all-cause mortality and MI in both East Asians and Western -ers. East Asians benefited more than Westerners upon using IVUS-guided PCI in reducing MACE, suggesting that racial differences do exist between different imaging methods. Larger-sample studies are warranted for further clarification of our findings.
