Impact of Optical Coherence Tomography-Based Post-PCI Physiology Assessment to Predict Clinical Outcomes: An ILUMIEN-IV Substudy
Authors' conclusion
Post-PCI OCT-based VFR assessment is predictive of 2-year clinical outcomes independent of MSA.
Study context
- Population
- Patients with DM or high-risk coronary lesions undergoing single-lesion PCI with final optical coherence tomography (OCT) imagingVirtual flow reserve (VFR) analysed in 2,057 (96.6%)
- Participants
- 2,128 patients
- Comparison
- Post-PCI OCT-based VFR as predictor of 2-year outcomes, independent of minimal stent area (MSA)
- Primary endpoint
- TVF (cardiac death, target-vessel MI, ischemia-driven target vessel revascularization)
- Follow-up
- 2 years
Methodological detailsmulticentre, retrospective offline post-PCI VFR analysis, multivariable analysis
- Multicentre
- Retrospective offline post-PCI VFR analysis
- Multivariable analysis
Primary result
As reported in the abstract
Independent predictors of 2-year TVF
- MSA (per 1 mm²) and VFR (per 0.1 mm Hg/mm Hg) both independent predictors of 2-year target vessel failure (TVF) (multivariable analysis)
Further findings
Median
| Outcome | Angiography-guided | OCT-guided | P value |
|---|---|---|---|
| Post-PCI VFR | 0.89 (IQR 0.86–0.92) | 0.90 (IQR 0.87–0.92) | P < 0.001 |
- Post-PCI VFR — Overall median post-PCI VFR
- 0.90 (Q1-Q3: 0.86-0.92)
TVF and target lesion failure
- MSA, proximal edge dissection and VFR independently predicted both TVF and target lesion failure
Original publication
Impact of Optical Coherence Tomography-Based Post-PCI Physiology Assessment to Predict Clinical Outcomes: An ILUMIEN-IV Substudy. J Am Coll Cardiol. Published 22 May 2025. doi:10.
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