Impact of Intravascular Imaging-Guided Stent Optimization According to Clinical Presentation in Patients Undergoing Complex Percutaneous Coronary Intervention (PCI)
Authors' conclusion
No significant interaction was observed between the benefits of intravascular imaging and clinical presentation in the risk of TVF. Stent optimization by intravascular imaging was particularly important for ACS patients.
Study context
- Population
- Patients with complex coronary artery lesions undergoing PCI832 acute coronary syndrome (ACS), 807 CCS
- Participants
- 1,639 patients
- Comparison
- Intravascular imaging-guided PCI vs angiography-guided PCI, by clinical presentation (ACS vs CCS)
- Primary endpoint
- Target vessel failure (TVF) (cardiac death, target vessel-related MI or clinically driven target vessel revascularization)
- Follow-up
- Median 2.1 years (Q1-Q3: 1.4-3.0 years)
Methodological detailsprespecified, stratified subgroup analysis, 2:1 randomisation
- Prespecified, stratified subgroup analysis
- 2:1 randomisation
Primary result
As reported in the abstract
TVF by clinical presentation · median 2.1 years
Intravascular imaging vs AngiographyHazard ratio (95% CI)P value
ACS: 10.4% vs 14.6%
0.74(0.48–1.15)
P = 0.18CCS: 5.0% vs 10.4%
0.46(0.27–0.80)
P = 0.006Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| TVF, optimized vs unoptimized stent by intravascular imaging (imaging arm)Optimizedvs UnoptimizedACS: 6.5% vs 14.1% | 0.49 (0.27–0.87) | P = 0.02 | |
| TVF, optimized vs unoptimized stent by intravascular imaging (imaging arm)Optimizedvs UnoptimizedCCS: 5.4% vs 4.7% | 1.18 (0.53–2.59) | P = 0.69 | |
| 0.20.5125Hazard ratio (log scale) |
Original publication
Impact of Intravascular Imaging-Guided Stent Optimization According to Clinical Presentation in Patients Undergoing Complex PCI. JACC Cardiovasc Interv. Published 27 May 2024. doi:10.
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