Coronary disease & ACSSecondary analysis
Optical coherence tomography-guided percutaneous coronary intervention in multivessel coronary disease with complex lesions
- post hoc subgroup analysis of the OCCUPI trial
Authors' conclusion
In patients with MVD and complex lesions, OCT-guided PCI was associated with a lower risk of 1-year MACE than angiography-guided PCI particularly when stent optimisation on OCT was achieved.
Study context
- Population
- Patients with multivessel disease (MVD) (diameter stenosis ≥50% in ≥2 major epicardial coronary arteries) with at least one complex lesion undergoing percutaneous coronary intervention (PCI)patients with MVD among the as-treated population in the OCCUPI trial (n=1604), 575 had single-vessel disease
- Participants
- 985 patients
- Comparison
- Optical coherence tomography (OCT)-guided PCI vs angiography-guided PCI in patients with MVD
- OCT-guided PCIn = 515
- angiography-guided PCIn = 470
- Primary endpoint
- MACE, a composite of cardiac death, myocardial infarction, stent thrombosis or ischaemia-driven target-vessel revascularisation
- Follow-up
- 1 year
Primary result
As reported in the abstract
Hazard ratio
0.51
95% CI 0.31–0.85
P = 0.008
By group
OCT-guided PCI vs angiography-guided PCI
HR 0.51 (95% CI 0.31–0.85); P = 0.008
Further findings
Achievement of prespecified OCCUPI optimisation criteria among OCT-guided patients
- achieved optimisation criteria
- 355 (70.2%)
- did not achieve optimisation criteria
- 151 (29.8%)
Major adverse cardiac event (MACE) by stent optimisation (optimised vs not optimised)
- stent optimisation vs no optimisation MACE rates
- 3.1% vs 8.6%; p=0.011
- consistent benefits across MVD and single-vessel disease (p for interaction=0.521)
Original publication
Optical coherence tomography-guided percutaneous coronary intervention in multivessel coronary disease with complex lesions. Heart. Published 26 August 2026. doi:10.1136/heartjnl-2026-328499
Summarised from the published abstract; every number is checked against it