Intravascular diagnostic procedures and imaging techniques versus angiography alone in coronary artery stenting: comparative effectiveness review
Raman G, Yu W, Ip S, Salvi P, Kong Win Chang L, Iovin RC, Rao M, Kitsios GD, Alonso A, Lau J
Record ID 32013000245
English
Authors' objectives:
To systematically review the comparative effectiveness of intravascular diagnostic techniques versus angiography alone in patients with coronary artery disease who are undergoing percutaneous coronary interventions for the following objectives: (a) to decide whether a coronary lesion needs to be stented; (b) to guide and optimize stent deployment; (c) to assess whether stent placement was successful; and (d) to evaluate the factors influencing the diagnostic techniques' effect on outcomes.
Authors' recommendations:
There is a moderate strength of evidence that the use of FFR (as compared with angiography alone) to decide whether or not to stent an intermediate coronary lesion confers a lower risk of composite endpoint of death or MI, or of major adverse cardiac events; leads to fewer stents being implanted; and reduces procedural costs. There is a moderate strength of evidence that the use of IVUS (as compared with angiography alone) to guide optimal stent
placement reduces repeat revascularization and restenosis, but does not affect mortality or MI.
Future studies will need to focus on women and on patients with more severe coronary artery disease, and to evaluate longer term (on the order of years) patient outcomes to better appreciate real world effectiveness. Stenting low-risk lesions may lead to additional invasive tests or treatments that could adversely impact long-term outcomes. Further research is also needed to evaluate the use of hybrid and novel intravascular diagnostic techniques.
Details
Project Status:
Completed
Year Published:
2013
URL for published report:
http://effectivehealthcare.ahrq.gov/ehc/products/299/1412/Coronary-Artery-Stenting-130226.pdf
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
United States
MeSH Terms
- Humans
- Imaging, Three-Dimensional
- Image Interpretation, Computer-Assisted
- Coronary Angiography
- Stents
Contact
Organisation Name:
Agency for Healthcare Research and Quality
Contact Address:
Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;
Contact Name:
martin.erlichman@ahrq.hhs.gov
Contact Email:
martin.erlichman@ahrq.hhs.gov
Copyright:
Agency for Healthcare Research and Quality (AHRQ)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.