Geographic Variability in Outcomes of IVUS-Guided Versus Angiography-Guided PCI: Insights from a Meta-Analysis of Randomized Trials

Highlight

• IVUS-guided PCI significantly reduces cardiac death and adverse cardiovascular events overall compared to angiography-guided PCI.
• There is substantial geographic heterogeneity: East Asian trials report pronounced benefits, whereas non-Asian trials demonstrate neutral or no significant advantage for IVUS guidance in cardiac death.
• Reductions in target-vessel myocardial infarction, revascularization, and major adverse cardiovascular events mirror the geographic pattern seen for cardiac death.
• Definite stent thrombosis is consistently reduced by IVUS guidance regardless of geographic location.

Study Background