Coronary disease & ACSCohort study
Impact of Intravascular Imaging on Clinical Outcomes in Focal Versus Diffuse Coronary Artery Disease
- Prospective, multicenter, single-arm study
Authors' conclusion
In patients undergoing physiology-guided PCI, the use of IVI reduced clinical events at 1 year. These findings suggest that the benefit of IVI extends across the full spectrum of coronary artery disease.
Study context
- Population
- Patients undergoing percutaneous coronary intervention (PCI), with focal or diffuse coronary artery disease defined by pullback pressure gradient (PPG)patients (840 vessels)
- Participants
- 811 patients
- Exposure
- PCI with or without intravascular imaging (IVI) guidance in patients with focal and diffuse disease defined by PPG
- Outcome
- Target vessel failure
- Follow-up
- 1-year follow-up
Main finding
As reported in the abstract
Adjusted hazard ratio
0.60
95% CI 0.36–0.99
P = 0.044
IVI-guided PCI vs PCI without IVI guidance
adjusted hazard ratio 0.60 (95% CI 0.36–0.99); P = 0.044
Observational data: associations, not effects.
Further findings
| Outcome | unadjusted HR (95% CI) | P value | |
|---|---|---|---|
| Target vessel failure, by disease pattern (focal vs diffuse) — IVI-guided PCI vs PCI without IVI guidance · focal disease | 0.41 (0.18–0.91) | P = 0.029 | |
| Target vessel failure, by disease pattern (focal vs diffuse) — IVI-guided PCI vs PCI without IVI guidance · diffuse disease | 0.91 (0.48–1.73) | P = 0.771 | |
| 0.20.5125Unadjusted hazard ratio (log scale) |
- Target vessel failure, by disease pattern (focal vs diffuse): P for interaction=0.128
Cardiac death
- Lower incidence of cardiac death with IVI guidance
- P = 0.042
IVI use
- IVI-guided PCI performed in
- 41% of patients
Original publication
Impact of Intravascular Imaging on Clinical Outcomes in Focal Versus Diffuse Coronary Artery Disease. Circ Cardiovasc Interv. Published 20 May 2026. doi:10.1161/circinterventions.126.016735
Summarised from the published abstract; every number is checked against it