Intravascular Imaging Predictors Associated With Cardiovascular Events After Complex Percutaneous Coronary Intervention (PCIs)
Primary result · Target lesion failure (TLF), a composite of cardiac death, target lesion-related myocardial infarction, target lesion revascularization, or definite stent thrombosisResult — go to the resultAdjusted hazard ratio 3.09 95% CI 1.01–9.50Authors' conclusion
After intravascular imaging-guided PCI with contemporary drug-eluting stents for nonleft main complex lesions, inadequate absolute stent expansion was independently associated with a higher risk of TLF. Suboptimal post-PCI intravascular imaging findings of relative stent underexpansion, major malapposition, and major dissection seem to contribute to the risk of TLF.
Study context
- Population
- Patients with complex coronary artery lesions undergoing intravascular imaging-guided PCI with contemporary drug-eluting stents, nonleft main target lesionspatients undergoing imaging-guided PCI, 897 nonleft main lesions
- Participants
- 714 patients
- Comparison
- Minimum stent area (MSA)<5.5 mm 2 vs MSA≥5.5 mm 2
- Primary endpoint
- Target lesion failure (TLF), a composite of cardiac death, target lesion-related myocardial infarction, target lesion revascularization, or definite stent thrombosis
- Follow-up
- Median of 2.1 years
Methodological detailspost-PCI intravascular imaging findings assessed in nonleft main target lesions, imaging-guided PCI arm
- post-PCI intravascular imaging findings assessed in nonleft main target lesions
- Imaging-guided PCI arm
Primary result
As reported in the abstract
Adjusted hazard ratio
3.09
95% CI 1.01–9.50
P = 0.048
MSA<5.5 mm 2 vs MSA≥5.5 mm 2
adjusted hazard ratio 3.09 (95% CI 1.01–9.50); P = 0.048
Further findings
| Outcome | Values |
|---|---|
| TLF, MSA≥5.5 mm 2 with relative stent underexpansion, major malapposition, or major dissection vs reference groupNumerically increased risk | reference group 0.0% · MSA≥5.5 mm 2 with suboptimal findings 3.2% |
| TLF, MSA<5.5 mm 2 with suboptimal findings vs reference group | reference group 0.0% · MSA<5.5 mm 2 with suboptimal findings 4.7% |
- Target lesion failure (TLF), MSA≥5.5 mm 2 with relative stent underexpansion, major malapposition, or major dissection vs reference group: P =0.057
- TLF, MSA<5.5 mm 2 with suboptimal findings vs reference group: P =0.017
Original publication
Intravascular Imaging Predictors Associated With Cardiovascular Events After Complex PCIs. Circ Cardiovasc Interv. Published 18 February 2025. doi:10.
Summarised from the published abstract; every number is checked against it