Mid Term Outcomes of PCI Guided With Intravascular Ultrasound Versus Angiography Alone in Acute Coronary Syndrome Within an Urban Center
Document Type
Conference Proceeding
Publication Date
5-2025
Publication Title
Journal of the Society for Cardiovascular Angiography and Interventions
Abstract
Background: Intravascular ultrasound (IVUS) helps optimize stent placement and identify high-risk plaque characteristics during PCI. However, the added cost and procedural time can prevent more routine use. Furthermore, African Americans (AA) have been underrepresented in previous trials evaluating IVUS. Methods: We conducted a single-center retrospective study to evaluate outcomes of PCI with IVUS versus Angio in ACS at our high-burden, urban center. Multivariable logistic regression analysis was used to evaluate outcomes between cohorts, adjusting for demographic and clinical covariates. Results: A total of 1532 patients were included, with 223 in the IVUS group and 1299 in the Angio group. AA consisted of at least 48% of the population, and 11% of included patients were uninsured or on Medicaid. At 6 months, patients who underwent IVUS had a higher risk of all-cause mortality (Odds Ratio 2.171, 95% Confidence Interval 1.01- 4.68, p =0.049) on multivariate analysis compared to Angio. However, this risk was eliminated at 12 months. Furthermore, on multivariate analysis, there was a lower risk of readmission for heart failure exacerbation (OR 0.113, 95% CI 0.13-0.99, p = 0.049) in the IVUS group versus the Angio group. Conclusions: While IVUS can improve outcomes, it is often used in patients with higher risk profiles and complex coronary anatomy, which can lead to increased mortality in the early midterm. Our study contained a significant number of underinsured patients, which can prevent optimal follow-up and management of comorbidities. Once the initial risk is mitigated, outcomes are the same regardless of IVUS use.
Volume
4
Issue
5 Suppl
First Page
34
Last Page
35
Recommended Citation
Hanmandlu A, Basit J, Hamza M, Husainy B, Salar A, Pareddy AR, et al. [Ahmed H]. Mid term outcomes of PCI guided with intravascular ultrasound versus angiography alone in acute coronary syndrome within an urban center. J Soc Cardiovasc Angiogr Interv. 2025 May;4(Suppl 5):34-35. doi:10.1016/j.jscai.2025.103198
DOI
10.1016/j.jscai.2025.103198
Comments
Society for Cardiovascular Angiography and Interventions SCAI 48th Annual Scientific Sessions, May 1-3, 2025, Washington, DC