Lagging But Improving - Intracoronary Imaging Use to Guide PCI Among Patients with Acute Coronary Syndromes: A Report from the BMC2 Registry

Document Type

Conference Proceeding

Publication Date

10-2025

Publication Title

Journal of the American College of Cardiology

Abstract

BACKGROUND: Owing to superior clinical outcomes, use of intracoronary imaging (ICI) to guide percutaneous coronary intervention (PCI) in acute coronary syndromes (ACS) has recently been given a Class I recommendation by US guidelines. This analysis was performed to evaluate the frequency of ICI use among patients with ACS.

METHODS: Using data from a large statewide registry, all patients undergoing PCI between January 1, 2019 and December 31, 2024 were studied. The primary measure of interest for this analysis was use of ICI to guide PCI, defined as use of ICI after the decision was made to proceed with PCI. Frequency of ICI use among patients with and without ACS were compared and the trend in ICI use in ACS patients over the study period was examined.

RESULTS: During the six-year study period, 166,238 PCIs were performed at 48 non-federal hospitals in Michigan, 90,441 (54.4%) of which were performed for ACS and 75,797 (45.6%) for non-ACS indications. ICI was used to guide PCI in 25,234 (27.9%) ACS cases, which was significantly lower than ICI use in 23,999 (31.7%) non-ACS cases (p < 0.001). Over the six-year study, a progressive and significant increase in ICI use in ACS was observed from 6.5% in the first year to 54.4% in the sixth year of the study (p < 0.001 for trend; Figure).

CONCLUSION: Despite its proven benefits in ACS, ICI is used to guide PCI significantly less often in ACS patients compared to patients without ACS. However, ICI to guide PCI in ACS is increasing significantly over time.

Volume

86

Issue

17 Suppl

First Page

B268

Comments

American College of Cardiology Thirty-Seventh Annual Transcatheter Cardiovascular Therapeutics Symposium, October 25-28, 2025, San Francisco, CA

Frederik Meijer Heart & Vascular Institute

Last Page

B269

DOI

10.1016/j.jacc.2025.09.762

ISSN

1558-3597

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