OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions

doi:10.1056/nejmoa2307770

Coronary disease & ACSRandomised controlled trial

Optical Coherence Tomography (OCT) or Angiography Guidance for Percutaneous Coronary Intervention (PCI) in Complex Bifurcation Lesions

N Engl J MedPublished 27 Aug 2023

Randomised controlled trial
multicentre
open-label
38 centres in Europe

Read the original article ↗

Authors' conclusion

Among patients with complex coronary-artery bifurcation lesions, OCT-guided PCI was associated with a lower incidence of MACE at 2 years than angiography-guided PCI.

Study context

Population: Patients with a clinical indication for PCI and a complex bifurcation lesion on coronary angiography
Participants: 1,201 patients

Comparison: OCT-guided PCI vs angiography-guided PCI
OCT-guided PCIn = 600
Angiography-guided PCIn = 601reference
Primary endpoint: Major adverse cardiac events (MACE):
Cardiac death
Target-lesion MI
Ischemia-driven target-lesion revascularization
Follow-up: Median 2 years

Primary result

As reported in the abstract

median 2 years

Hazard ratio

0.70

95% CI 0.50–0.98

P = 0.035

Events by treatment group

OCT-guided PCI10.1%59 of 600

Angiography-guided PCI14.1%83 of 601

OCT-guided PCI vs Angiography-guided PCI

HR 0.70 (95% CI 0.50–0.98); P = 0.035

Further findings

Bifurcation lesion involving the left main coronary artery (baseline)

OCT-guided PCI18.5%

Angiography-guided PCI19.3%

Safety

Procedure-related complications

OCT-guided PCI6.8%

Angiography-guided PCI5.7%

Original publication

OCT or Angiography Guidance for PCI in Complex Bifurcation Lesions. N Engl J Med. Published 27 August 2023. doi:10.1056/nejmoa2307770

Read the original article ↗PubMedCite RIS · BibTeX

Summarised from the published abstract; every number is checked against it