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.
