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Does intravascular ultrasound provide clinical benefits for percutaneous coronary intervention with bare-metal stent implantation? A meta-analysis of randomized controlled trials

机译：血管内超声通过裸金属支架植入术对经皮冠状动脉介入治疗是否有临床益处？随机对照试验的荟萃分析

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Background The role of intravascular ultrasound (IVUS) in percutaneous coronary interventions (PCI) is still controversial despite several previously published meta-analyses. A meta-analysis to evaluate the controversial role of IVUS-guided PCI with bare-metal stenting was performed and a previous published meta-analysis was re-evaluated in order to clarify the discrepancy between results of these studies. Methods A systematic review was performed by an electronic search of the PubMed, Embase and Web of Knowledge databases and by a manual search of reference lists for randomized controlled trials published until April 2011, with clinical outcomes and, at least, six months of clinical follow-up. A meta-analysis based on the intention to treat was performed with the selected studies. Results Five studies and 1,754 patients were included. There were no differences in death (OR?=?1.86; 95% CI?=?0.88-3.95; p?=?0.10), non-fatal myocardial infarction (OR?=?0.65; 95% CI?=?0.27-1.58; p?=?0.35) and major adverse cardiac events (OR?=?0.74; 95% CI?=?0.49-1.13; p?=?0.16). An analysis of the previous published meta-analysis strongly suggested the presence of publication bias. Conclusions There is no evidence to recommend routine IVUS-guided PCI with bare-metal stent implantation. This may be explained by the paucity and heterogeneity of the studies published so far.
机译：背景技术尽管先前发表了一些荟萃分析，但血管内超声（IVUS）在经皮冠状动脉介入治疗（PCI）中的作用仍存在争议。进行了荟萃分析，以评估IVUS引导的PCI与裸金属支架的争议作用，并重新评估了先前发表的荟萃分析，以阐明这些研究结果之间的差异。方法通过对PubMed，Embase和Web of Knowledge数据库的电子搜索以及对截至2011年4月为止发表的随机对照试验的参考文献列表的人工搜索，进行了系统的评价，并获得了临床结果以及至少六个月的临床随访-向上。对所选研究进行了基于治疗​​意向的荟萃分析。结果包括5项研究和1,754例患者。非致命性心肌梗死的死亡无统计学差异（OR = 1.86; 95％CI = 0.88-3.95; p = 0.10）（OR = 0.65; 95％CI = 0.27-。 1.58;p≤0.35）和主要的不良心脏事件（OR ＝ 0.74; 95％CI ＝ 0.49-1.13; p ＝ 0.16）。对先前已发表的荟萃分析的分析强烈表明存在出版偏见。结论没有证据推荐常规IVUS引导的PCI裸金属支架植入术。迄今为止发表的研究的稀缺性和异质性可以解释这一点。

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