Coronary disease & ACSSecondary analysis
Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial
- Secondary analysis of the ILUMIEN IV randomised trial
- prospective
- single-blind
Authors' conclusion
In the ILUMIEN IV trial, the most important OCT-derived post-DES predictors of both safety and effectiveness outcomes were parameters related to stent area, expansion and flow, proximal edge dissection, and stent length.
Study context
- Population
- Patients with diabetes or high-risk lesions undergoing drug-eluting stent (DES) implantation (optical coherence tomography (OCT)-guided or angiography-guided), single treated lesion with core laboratory-analysed final OCTof 2487 randomised
- Participants
- 2,128 patients
- Comparison
- OCT-derived post-DES parameters as predictors of clinical outcomes
- Primary endpoint
- Target lesion failure (TLF)
- Follow-up
- 2 years
Primary result
As reported in the abstract
Independent OCT predictors of 2-year TLF
Hazard ratio (95% CI)P value
Minimal stent area (per 1 mm² increase)smaller minimal stent area predicts TLF
0.76(0.68–0.89)
P < 0.0001Proximal edge dissection
1.77(1.20–2.62)
P = 0.004Per 1 mm² increase, as printed
- 2-year Kaplan-Meier target lesion failure (TLF) rate
- 6.3% (n = 130)
Further findings
Cardiac death or target-vessel myocardial infarction (TV-MI) · 2 years
- 2-year Kaplan-Meier rate
- 3.3% (n = 68)
- Independent predictors: smaller minimal stent area and longer stent length
Ischaemia-driven TLR (ischaemia-driven target lesion revascularization (ID-TLR)) · 2 years
- 2-year Kaplan-Meier rate
- 4.3% (n = 87)
- Independent predictors: smaller intra-stent flow area and proximal edge dissection
Stent thrombosis · 2 years
- 2-year Kaplan-Meier rate
- 0.9% (n = 18)
- Independent predictor: smaller minimal stent expansion
Original publication
Optical coherence tomography predictors of clinical outcomes after stent implantation: the ILUMIEN IV trial. Eur Heart J. Published 28 August 2024. doi:10.1093/eurheartj/ehae521
Summarised from the published abstract; every number is checked against it