Comparison of prognosis between intravascular ultrasound-guided and angiography-guided percutaneous coronary intervention in patients with acute coronary syndrome.

OBJECTIVE

To compare the prognosis of intravascular ultrasound (IVUS)-guided versus angiography-guided percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).

METHODS

This retrospective cohort study included 190 ACS patients who underwent PCI between January 2019 and January 2024. Patients were equally divided into two groups: IVUS-guided (n=95) and angiography-guided PCI (n=95). Baseline characteristics, procedural details, and clinical outcomes were analyzed. Follow-up duration was one year. Primary endpoints included cardiac function parameters, target vessel-related events, major adverse cardiovascular and cerebrovascular events , and quality of life (QoL) measures.

RESULTS

The IVUS-guided group demonstrated better procedural outcomes, with significantly lower stent volume (P=0.002) and reduced neointima volume at 9 months (P=0.002). Improvements in cardiac function were more notable in the IVUS group, reflected in lower post-treatment left ventricular end-diastolic volume index (P=0.004) and end-systolic volume index (P=0.003). QoL scores were significantly higher in physical function (P=0.001) and social function (.002). However, IVUS-guided procedures required longer procedural time and greater contrast media use.

CONCLUSION

IVUS-guided PCI yields superior procedural precision, improved cardiac function, and better quality of life compared to angiography-guided PCI in ACS patients, with acceptable trade-offs in procedural complexity.