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Optical coherence tomography guidance in percutaneous coronary intervention: a meta-analysis of randomized controlled trials

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Abstract

The benefit of optical coherence tomography (OCT) guidance in percutaneous coronary intervention (PCI) is unclear. We aimed to assess the incremental value of adding OCT to coronary angiography in PCI by meta-analytic technique. We searched PubMed, EMBASE, Cochrane, Scopus and relevant references for randomized studies (inception through January 5, 2018 without language restrictions) and performed meta-analysis using random effects model. Major adverse cardiac events (MACE), all-cause mortality, myocardial infarction, target vessel revascularization, stent thrombosis, fluoroscopic time, contrast volume, and procedural side effects were the measured outcomes. Five randomized studies with a total population of 931 were analyzed. There was no difference in MACE between angiography plus OCT and angiography alone arms (2.5 vs. 2.0% OR 1.26; 95% CI 0.40–3.99; P = 0.69; I2 = 5%). Two groups were not different in terms of all-cause mortality (0.2 vs. 0% OR 3.03; 95% CI 0.12–75; P = 0.5; I2 = not applicable), myocardial infarction (1 vs. 0.2% OR 2.21; 95% CI 0.39–12.49; P = 0.3; I2 = 0%), target vessel revascularization (1.6 vs. 1.2% OR 1.36; 95% CI 0.4–4.4; P = 0.6; I2 = 0%), and stent thrombosis (0.2 vs. 0.5% OR 0.7; 95% CI 0.11–4.51; P = 0.7; I2 = 0%). OCT group had significantly higher fluoroscopic time and contrast volume. Our meta-analysis shows that the addition of OCT to angiography for PCI guidance is not associated with lower MACE, all-cause mortality, myocardial infarction, target vessel revascularization, or stent thrombosis. It is associated with longer fluoroscopic time and higher contrast volume.

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Authors and Affiliations

  1. University of New England, LRGHealthcare, 80 Highland Street, Laconia, NH, 03246, USA

    Sharan Prakash Sharma

  2. Hartford Heart and Vascular Institute, Hartford Hospital, Hartford, CT, USA

    Jharendra Rijal

  3. Division of Cardiology, Louisiana State University Health Science Center, Shreveport, LA, USA

    Khagendra Dahal

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  1. Sharan Prakash Sharma
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  2. Jharendra Rijal
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Contributions

Conception and design: SPS and KD. Provision of study material: SPS and KD. Collection and assembly of data: all authors. Data analysis and interpretation: all authors. Manuscript writing: all authors. Final approval of manuscript: all authors.

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Correspondence to Sharan Prakash Sharma.

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Supplementary Fig. 1 Cochrane collaboration risk of bias graph (TIFF 141 kb)

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Sharma, S.P., Rijal, J. & Dahal, K. Optical coherence tomography guidance in percutaneous coronary intervention: a meta-analysis of randomized controlled trials. Cardiovasc Interv and Ther 34, 113–121 (2019). https://doi.org/10.1007/s12928-018-0529-6

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  • DOI: https://doi.org/10.1007/s12928-018-0529-6

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