Coronary disease & ACSSecondary analysis
Impact of Diabetes on Outcomes of Contemporary Percutaneous Coronary Intervention (PCI) Guided by Optical Coherence Tomography (OCT) vs Angiography
- Secondary analysis of the ILUMIEN IV randomised trial
Authors' conclusion
In the large-scale ILUMIEN IV trial, patients with diabetes remained at increased risk for adverse events after PCI compared with nondiabetic patients despite the use of OCT procedural guidance. Patients with diabetes and complex lesions were at particularly high risk for adverse outcomes after PCI.
Study context
- Population
- Patients randomised to OCT-guided vs angiography-guided PCI in ILUMIEN IV
- Participants
- 1,044 vs 1,443
- Comparison
- Diabetes vs no diabetes
- Diabetesn = 1,044
- No diabetesn = 1,443reference
- Primary endpoint
- TVF and serious MACE
- Follow-up
- 2 years
Primary result
TVF
Adjusted hazard ratio
1.48
95% CI 1.09–2.02
P = 0.01
By group
Diabetes vs No diabetes
adjusted HR 1.48 (95% CI 1.09–2.02); P = 0.01
As reported in the abstract
Further findings
| Outcome | Diabetes | No diabetes | adjusted HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Serious MACE · 2 years | 5.3% | 2.7% | 1.77 (1.14–2.76) | P = 0.01 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
OCT vs angiography guidance: Target vessel failure (TVF) and serious major adverse cardiovascular events (MACE)
- OCT guidance did not reduce TVF or serious MACE; consistent with and without diabetes
- Pinteraction = 0.41 and 0.20, respectively
Original publication
Impact of Diabetes on Outcomes of Contemporary PCI Guided by OCT vs Angiography. JACC Cardiovasc Interv. Published 14 September 2026. doi:10.1016/j.jcin.2026.06.028
Summarised from the published abstract; every number is checked against it