Intravascular Imaging-Guided Versus Angiography-Guided Complex Percutaneous Coronary Intervention (PCI) in Patients With High Bleeding Risk: A Secondary Analysis of the RENOVATE-COMPLEX PCI Trial
Authors' conclusion
Patients with HBR were associated with an increased risk of adverse cardiovascular events after complex PCI compared with those without HBR. Intravascular imaging-guided PCI showed a lower risk of the target vessel failure without significant interaction between treatment strategy and the presence of HBR in patients undergoing complex PCI.
Study context
- Population
- Patients with complex coronary artery lesions undergoing PCI, classified according to the presence of high bleeding risk (HBR)trial population, 478 patients met HBR criteria · HBR 478
- Participants
- 1,639 patients
- Comparison
- Intravascular imaging-guided PCI vs angiography-guided PCI, by presence of HBR; HBR vs non-HBR
- HBRn = 478
- Primary endpoint
- Target vessel failure:
- Cardiac death
- Target vessel-related myocardial infarction
- Clinically driven target vessel revascularization
Methodological detailsrandomized, 20 sites in Korea
- Randomized
- 20 sites in Korea
Primary result
As reported in the abstract
Adjusted hazard ratio (95% CI)P value
HBR vs non-HBR
1.05(0.72–1.54)
P = 0.790Intravascular imaging-guided PCI vs angiography-guided PCIHBR patients: 9.7% versus 15.8%
0.57(0.31–1.02)
P = 0.060Intravascular imaging-guided PCI vs angiography-guided PCInon-HBR patients: 6.9% versus 10.8%
0.65(0.43–0.99)
P = 0.045Further findings
| Outcome | Adjusted HR (95% CI) | P value | |
|---|---|---|---|
| Cardiac death or spontaneous target vessel-related myocardial infarctionHBR vs non-HBR | 2.04 (1.09–3.80) | P = 0.025 | |
| All-cause deathHBR vs non-HBR | 3.30 (1.93–5.62) | P < 0.001 | |
| Cardiac deathHBR vs non-HBR | 2.36 (1.10–5.09) | P = 0.028 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Original publication
Intravascular Imaging-Guided Versus Angiography-Guided Complex PCI in Patients With High Bleeding Risk: A Secondary Analysis of the RENOVATE-COMPLEX PCI Trial. Circ Cardiovasc Interv. Published 18 March 2025. doi:10.
Summarised from the published abstract; every number is checked against it