Coronary disease & ACSCohort study
Optical coherence tomography-guided stent optimization and clinical outcomes in all-comer patients with ST-elevation myocardial infarction
- prospective, multicentre, single-arm study
Authors' conclusion
In STEMI, suboptimal MSA and SE determined by OCT were associated with higher adverse event risk. These findings support OCT-guided PCI optimization to improve outcomes and warrant further evaluation in randomized trials.
Study context
- Population
- ST-elevation myocardial infarction (STEMI) patients within 24 h of symptom onset with analysable post-PCI optical coherence tomography (OCT) images (all-comer STEMI population)of 632 patients, 439 (69.5%) underwent OCT-guided stenting with final analysable imaging
- Participants
- 439 patients
- Exposure
- association between OCT findings after stent implantation and 1-year outcomes
- Outcome
- target vessel failure:
- TVF
- All-cause death
- Target vessel myocardial infarction [TVMI]
- Target vessel revascularization [TVR]
- Follow-up
- 12 months
Main finding
As reported in the abstract
Hazard ratio
2.57
95% CI 1.29–5.11
By group
Suboptimal expansion vs Optimal
HR 2.57 (95% CI 1.29–5.11)
- Each 1 mm² minimal stent area (MSA) decrease increased target vessel failure (TVF) odds
- 23%
- Each 10% SE reduction increased TVF odds
- 33%
Observational data: associations, not effects.
Further findings
Post-PCI OCT stent metrics
- Mean minimal stent area (MSA)
- 6.21 ± 2.27 mm²
- Stent expansion (SE)
- 76.8 ± 15.6%
- Optimization criteria met
- 87.7%
Minor OCT findings
- Not significantly associated with outcomes
Original publication
Optical coherence tomography-guided stent optimization and clinical outcomes in all-comer patients with ST-elevation myocardial infarction. Eur Heart J Cardiovasc Imaging. Published 2 February 2026. doi:10.1093/ehjci/jeag011
Summarised from the published abstract; every number is checked against it