Coronary CT Angiography versus Intravascular Ultrasound Guidance for Percutaneous Coronary Intervention (PCI)
Primary result · Target-vessel failure (composite of death from cardiac causes, target-vessel myocardial infarction, or ischemia-driven target-vessel revascularization)Result — go to the resultRisk difference −0.42 percentage points 95% CI −2.82 to 1.99Authors' conclusion
A CCTA-guided PCI strategy was noninferior to IVUS-guided PCI with respect to target-vessel failure at 12 months. (Funded by GE HealthCare and Heartflow; P4 ClinicalTrials.gov number, NCT05253677.).
Study context
- Population
- Patients with a clinical indication for revascularization, at least one epicardial lesion with a diameter stenosis of more than 70%, and a fractional flow reserve derived from coronary computed tomographic angiography (CCTA) of 0.80 or lessunderwent randomization
- Participants
- 1,105 patients
- Comparison
- CCTA-guided vs intravascular ultrasound (IVUS)-guided PCI strategy
- CCTA-guided PCIn = 556
- IVUS-guided PCIn = 549
- Primary endpoint
- Target-vessel failure:
- Death from cardiac causes
- Target-vessel myocardial infarction
- Ischemia-driven target-vessel revascularization
- Follow-up
- 12 months
Primary result
As reported in the abstract
Risk difference
−0.42 percentage points
95% CI −2.82 to 1.99
P < 0.001 for noninferiority; P = 0.73 for superiority
Events by treatment group
CCTA-guided PCI vs IVUS-guided PCI
risk difference −0.42 percentage points (95% CI −2.82 to 1.99); P < 0.001 for noninferiority; P = 0.73 for superiority
Further findings
Patient characteristics
- Median age of the patients
- 65 years
- Women
- 21.7%
Safety
Events
| Outcome | CCTA-guided PCI | IVUS-guided PCI |
|---|---|---|
| Clinical procedural complications | 6 | 9 |
Original publication
Coronary CT Angiography versus Intravascular Ultrasound Guidance for PCI. N Engl J Med. Published 1 November 2026. doi:10.
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