Comparison of the Guiding Value of IVUS and Coronary Angiography in the Decision-Making Process of PCI Intervention for Borderline Coronary Heart Disease

NIE Xiaodong; SHEN Zhifang; CHEN Gaoxiang; CAO Wei

doi:10.3969/j.issn.1004-437X.2025.19.020

Abstract：Objective To explore the guiding value of intravascular ultrasound(IVUS)and coronary artery angiography(CAG)in the decision-making process of percutaneous coronary intervention(PCI)for borderline coronary artery disease.Methods A total of 138 patients with borderline coronary artery disease admitted to the Third People's Hospital of Shangqiu from August 2021 to May 2024 were selected.Patients were assigned to CAG group and IVUS group by random number table method.Each group had 69 cases.The CAG group was given PCI or drug therapy based on the diagnosis of CAG and the operator's clinical experience.The IVUS group underwent IVUS examination after CAG examination and was given PCI or drug therapy based on the results of the IVUS examination.The PCI intervention decision guidance indicators[reference lumen diameter(RVD),diameter stenosis rate(DS％),minimum lumen area(MLA),lumen area stenosis rate(AS％),minimum lumen diameter(MLD)],PCI rate and efficacy were compared,as well as angina attack,microRNA-33a(miR-33a),miR-126 before and after treatment.And the occurrence of major adverse cardiovascular events(MACE)was also compared.Results Patients detected by IVUS had higher DS％and AS％and lower MLA than those detected by CAG,with statistically significant differences(P＜0.05).The PCI rate in the IVUS group was 53.62％,higher than that in the CAG group(23.19％),and the total effective rate was 91.30％,higher than that in the CAG group(75.36％),with statistically significant differences(P＜0.05).After treatment,patients in the IVUS group had lower attack frequency,attack duration,and visual analog scale(VAS)scores than those in the CAG group,with statistically significant differences(P＜0.05).After treatment,the level of miR-33a in the IVUS group was lower than that in the CAG group,while the level of miR-126 was higher,with statistically significant differences(P＜0.05).During a 6-month follow-up,the incidence of MACE in the IVUS group was lower than that in the CAG group,with a statistically significant difference(P＜0.05).Conclusion Compared with CAG,IVUS can more accurately display the extent of critical lesions in coronary heart disease,and is helpful in guiding PCI implementation to improve efficacy,alleviate patients' angina symptoms,and reduce the risk of MACE.