To compare the effects of intravascular ultrasound (IUVS) and optical coherence tomography (OCT) guided emergency percutaneous coronary intervention (PCI) on acute myocardial infarction.

A total of 80 patients with acute myocardial infarction admitted to our hospital from May 2023 to November 2024 were divided into IUVS group and OCT group, with 40 cases in each group; there were 47 males and 33 females, the age ranged from 51 to 73 years, with an average of (63.51±6.59) years. Emergency PCI under IVUS guidance was performed in the IVUS group, while emergency PCI under OCT guidance was performed in the OCT group. The preoperative characteristics of lesions (plaque rupture, plaque erosion, lipid and fibrous plaques, and calcified nodules), preoperative coronary conditions [minimum lumen area (MLA), reference vessel diameter, minimum lumen diameter, lesion length, and bifurcation lesion], perioperative situation (number of stent placement, intraoperative dilation times, minimum stent area after stent placement, stent placement success rate, and length of hospital stay), detection rate of immediate stent implantation defects after PCI (stent mal-expansion, poor adhesion, immediate thrombosis, marginal dissection, and tissue prolapse), the incidence of major adverse cardiovascular events (MACE) 30 days after surgery (angina pectoris, recurrent myocardial infarction, and malignant arrhythmias) were compared between the two groups.

The plaque rupture and plaque erosion in OCT group were higher than that in the IVUS group (P<0.05); the MLA, reference vessel diameter, minimum lumen diameter, lesion length and bifurcation lesion were compared between the two groups, with statistically significant (P>0.05); the intraoperative dilation times in OCT group were more than that in IVUS group, and the hospital stay was shorter than that in IVUS group (P<0.05); the total detection rate of stent implantation defects immediately after PCI in OCT group was higher than that in IVUS group (P<0.05); there was no statistical significance in the total incidence of 30dMACE between the two groups (P>0.05).

Compared with IVUS, OCT-guided emergency PCI is better in the treatment of patients with acute myocardial infarction, which can effectively identify the nature of preoperative lesions and improve the detection rate of poor stents, shorten hospital stay, and is worthy of clinical promotion.