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. 2025 Jul 15;17(7):5398-5410.
doi: 10.62347/GAKW8223. eCollection 2025.

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

Shiming Zhao  1 , Xiao Zeng  1 , Chenghuan Jiang  1 , Lei Hu  1 , Hui Li  1 , Jing Fei  1 , Yuanyuan Zhang  1
Affiliations

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

Shiming Zhao et al. Am J Transl Res. .

Abstract

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.

Keywords: Intravascular ultrasound; acute coronary syndrome; angiography-guided; cardiac function; percutaneous coronary intervention; quality of life.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Comparison of in-stent segment (3D analysis) at 9-month follow-up (per protocol set). A: Stent volume; B: Stent volume index; C: Lumen volume; D: Lumen volume index; E: Neointima volume; ns: no statistically significant difference; *: P<0.05; **: P<0.01. IVUS: intravascular ultrasound; AG: angiography-guided.
Figure 2
Figure 2
Comparison of cardiac function indicators. A: Pre-treatment LVEDVI; B: Post-treatment LVEDVI; C: Pre-treatment LVESVI; D: Post-treatment LVESVI. LVEDVI: left ventricular end-diastolic volume index; LVESVI: left ventricular end-systolic volume index; ns: no statistically significant difference; IVUS: intravascular ultrasound; AG: angiography-guided. **: P<0.01.
Figure 3
Figure 3
Comparison of major adverse cardiovascular and cerebrovascular events. ns: no significant; IVUS: intravascular ultrasound; AG: angiography-guided.
Figure 4
Figure 4
Comparison of quality of life scores across different domains post-PCI treatment. A: Physical function; B: Social function; C: Activities of daily living; D: Psychological function. **: P<0.01. IVUS: intravascular ultrasound; AG: angiography-guided.
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