Optical frequency domain imaging-guided versus intravascular ultrasound-guided percutaneous coronary intervention for acute coronary syndromes: the OPINION acute coronary syndrome (ACS) randomised trial
Authors' conclusion
Among ACS patients, OFDI-guided PCI and IVUS-guided PCI were equally safe and feasible, with comparable in-stent MLA at 8 months.
Study context
- Population
- Patients with ACS undergoing percutaneous coronary intervention (PCI) (STEMI 55%, NSTEMI 29%, unstable angina 16%)
- Participants
- 158 patients
- Comparison
- Optical frequency domain imaging (OFDI)-guided PCI vs intravascular ultrasound (IVUS)-guided PCI
- Primary endpoint
- In-stent minimum lumen area (MLA) by follow-up OFDI
- Follow-up
- 8 months
Methodological detailsmulticentre, prospective, non-inferiority
- Multicentre
- Prospective
- Non-inferiority
Primary result
As reported in the abstract
In-stent MLA
P for non-inferiority < 0.001
Further findings
| Outcome | P value |
|---|---|
| Minimum stent area immediately after PCITended to be smaller with OFDI | P = 0.096 |
| Proximal stent edge dissectionSignificantly less frequent with OFDI | P = 0.012 |
| Irregular protrusionSignificantly less frequent with OFDI | P = 0.03 |
| Post-PCI coronary flow (corrected TIMI frame count)Significantly better with OFDI | P < 0.001 |
Average neointima area
- Tended to be smaller with OFDI
Safety
Periprocedural complications
- Comparably low in both groups; procedural success in all patients
Major adverse cardiac events
- Frequency similar
Original publication
Optical frequency domain imaging-guided versus intravascular ultrasound-guided percutaneous coronary intervention for acute coronary syndromes: the OPINION ACS randomised trial. EuroIntervention. Published 2 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it