Coronary disease & ACSRandomised controlled trial
Computed Tomography Angiography or Standard Care After Left Main Percutaneous Coronary Intervention (PCI)?
- Randomised controlled trial
- prospective
- multicentre
- open-label
Coronary computed tomography angiography (CCTA) completed in 272/303 (89.8%) after median 200 days (IQR 181-270)
Authors' conclusion
Routine CCTA after LM PCI did not reduce the composite primary endpoint, but was associated with fewer spontaneous MIs and more imaging-triggered revascularizations.
Study context
- Population
- Patients after PCI with second-generation drug-eluting stents for unprotected left main disease
- Participants
- 606 patients
- Comparison
- CCTA-guided follow-up vs standard care after left main (LM) PCI
- CCTAn = 303
- Standard caren = 303reference
- Primary endpoint
- All-cause death, spontaneous myocardial infarction (MI), unstable angina, or definite or probable stent thrombosis
- Follow-up
- 18 months
Primary result
As reported in the abstract
Composite of:
- All-cause death
- Spontaneous MI
- Unstable angina
- Definite or probable stent thrombosis
Hazard ratio
0.97
95% CI 0.76–1.23
P = 0.80
Events by treatment group
Experimental vs Control
HR 0.97 (95% CI 0.76–1.23); P = 0.80
Secondary outcomes
| Outcome | CCTA | Standard care | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Spontaneous MI | 0.9% | 4.9% | 0.26 (0.07–0.91) | P = 0.004 | |
| Clinically driven TLR | 5.3% | 7.2% | 0.74 (0.38–1.41) | P = 0.32 | |
| 0.050.21520Hazard ratio (log scale) |
Safety
| Outcome | CCTA | Standard care | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Imaging-triggered TLR | 4.9% | 0.3% | 7.7 (1.70–33.7) | P = 0.001 | |
| 0.050.21520Hazard ratio (log scale) |
Original publication
Computed Tomography Angiography or Standard Care After Left Main PCI? J Am Coll Cardiol. Published 31 August 2025. doi:10.1016/j.jacc.2025.07.060
Summarised from the published abstract; every number is checked against it