Optical coherence tomography-guided percutaneous coronary intervention in acute coronary syndrome patients with complex lesions: a subgroup analysis of the randomised OCCUPI Trial
Authors' conclusion
In ACS patients with complex lesions, OCT-guided PCI demonstrated an evident cardiovascular benefit over angiography-guided PCI, a finding endorsed by current guidelines.
Study context
- Population
- Patients requiring drug-eluting stent implantation for complex lesions, by clinical presentation (acute coronary syndrome (ACS) vs chronic coronary syndrome)790 ACS, 814 chronic coronary syndrome (CCS)
- Participants
- 1,604 patients
- Comparison
- Optical coherence tomography (OCT)-guided vs angiography-guided percutaneous coronary intervention (PCI)
- Primary endpoint
- MACE:
- Cardiac death
- MI
- Stent thrombosis
- Ischaemia-driven target vessel revascularisation
- Follow-up
- 1 year
Methodological detailspost hoc analysis, subgroup analysis
- Post hoc analysis
- Subgroup analysis
Primary result
As reported in the abstract
Primary outcome by clinical presentation
OCT-guided vs Angiography-guidedHazard ratio (95% CI)P value
ACS: 4.9% vs 9.5%
0.50(0.29–0.87)
P = 0.011CCS: 4.4% vs 5.4%
0.80(0.43–1.50)
P = 0.479Further findings
| Outcome | Optimisation | Suboptimisation | HR (95% CI) | P value | |
|---|---|---|---|---|---|
| Primary outcome, stent optimisationvs suboptimisation (ACS, OCT-guided) | 2.9% | 9.7% | 0.29 (0.12–0.72) | P = 0.004 | |
| 0.10.31310Hazard ratio (log scale) |
Original publication
Optical coherence tomography-guided percutaneous coronary intervention in acute coronary syndrome patients with complex lesions: a subgroup analysis of the randomised OCCUPI Trial. EuroIntervention. Published 3 November 2025. doi:10.
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