Guiding Intervention for Complex Coronary Lesions by Optical Coherence Tomography or Intravascular Ultrasound
Primary result · Complex coronary lesions subgroupResult — go to the resultHazard ratio 0.87 95% CI 0.59–1.29Authors' conclusion
Among patients with complex coronary artery lesions, OCT-guided PCI showed a similar risk of primary composite event of death from cardiac causes, target vessel-related myocardial infarction, or target vessel revascularization as compared with IVUS-guided PCI.
Study context
- Population
- Patients undergoing imaging-guided percutaneous coronary intervention (PCI) for complex coronary artery lesions (unprotected left main, bifurcation, aorto-ostial, chronic total occlusion, severely calcified, in-stent restenotic, diffuse long lesion, or multivessel PCI)of 2,008 randomized
- Participants
- 1,475 patients
- Comparison
- Optical coherence tomography (OCT)-guided vs intravascular ultrasound (IVUS)-guided PCI
- OCT-guidedn = 719
- IVUS-guidedn = 756reference
- Primary endpoint
- Composite of:
- Cardiac death
- Target vessel-related MI
- Ischemia-driven target vessel revascularization
- Follow-up
- Median 2.0 years
Methodological detailsprespecified subgroup analysis
- Prespecified subgroup analysis
Primary result
Complex coronary lesions subgroup
Hazard ratio
0.87
95% CI 0.59–1.29
P = 0.50
Events by treatment group
OCT-guidedvs IVUS-guided
HR 0.87 (95% CI 0.59–1.29); P = 0.50
As reported in the abstract
Safety
Major procedural complications · lower with OCT-guided
P = 0.03
Contrast-induced nephropathy
- Similar between the 2 groups (1.9% vs 1.5%)
- P = 0.46
Original publication
Guiding Intervention for Complex Coronary Lesions by Optical Coherence Tomography or Intravascular Ultrasound. J Am Coll Cardiol. Published 23 October 2023. doi:10.
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