Coronary disease & ACSRandomised controlled trial
Optical Coherence Tomography–Guided versus Angiography-Guided percutaneous coronary intervention (PCI)
- Randomised controlled trial
- single-blind
- prospective
- 80 sites in 18 countries
Authors' conclusion
Among patients undergoing PCI, OCT guidance resulted in a larger minimum stent area than angiography guidance, but there was no apparent between-group difference in the percentage of patients with target-vessel failure at 2 years.
Study context
- Population
- Patients with medication-treated DM or complex coronary-artery lesions undergoing PCI
- Participants
- 2,487 patients
- Comparison
- Optical coherence tomography (OCT)-guided PCI vs angiography-guided PCI
- OCTn = 1,233
- Angiographyn = 1,254reference
- Primary endpoint
- Two primary efficacy end points: minimum stent area after PCI (by OCT) and target-vessel failure (cardiac death, target-vessel MI or ischemia-driven target-vessel revascularization)
- Follow-up
- 2 years (target-vessel failure)
Primary result
As reported in the abstract
OCT
5.72
± 2.04 · mm²
Angiography
5.36
± 1.87 · mm²
OCT
7.4%
88 of 1233
Angiography
8.2%
99 of 1254
OCT vs AngiographyMean difference, mm2 (95% CI)P value
minimum stent area after PCI
0.36(0.21–0.51)
P < 0.001OCT vs AngiographyHazard ratio (95% CI)P value
target-vessel failure within 2 years (Kaplan-Meier estimates 7.4% vs 8.2%)
0.90(0.67–1.19)
P = 0.45Safety
Stent thrombosis · within 2 years
events
| Outcome | OCT | Angiography |
|---|---|---|
| OCT-related adverse events | 1 | 2 |
Original publication
Optical Coherence Tomography–Guided versus Angiography-Guided PCI. N Engl J Med. Published 27 August 2023. doi:10.1056/nejmoa2305861
Summarised from the published abstract; every number is checked against it