Coronary disease & ACSSecondary analysis
Proportion and Clinical Impact of Stent Optimization During Imaging-Guided Percutaneous Coronary Intervention
- Secondary analysis of the OCTIVUS randomised trial
Authors' conclusion
Stent optimization was achieved in approximately one-half of patients undergoing imaging-guided PCI and was associated with a better clinical outcome. This effect appeared more pronounced in OCT-guided than in IVUS-guided PCI.
Study context
- Population
- Patients undergoing intravascular ultrasound (IVUS)- or optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) in the OCTIVUS trial
- Participants
- 1,980 patients
- Comparison
- Optimized vs nonoptimized stent deployment in imaging-guided PCI
- Optimizedn = 1,022
- Nonoptimizedn = 958reference
- Primary endpoint
- Target vessel failure:
- Cardiac death
- Target vessel MI
- Ischemia-driven target vessel revascularization
- Follow-up
- Median 2.0 years
Primary result
TVF
Hazard ratio
0.52
95% CI 0.35–0.77
P < 0.001
Events by treatment group
Optimized vs Nonoptimized
HR 0.52 (95% CI 0.35–0.77); P < 0.001
As reported in the abstract
Further findings
| Outcome | Values | HR (95% CI) | |
|---|---|---|---|
| TVF, optimized vs nonoptimized, by imaging modality (subgroup) — Optimized vs Nonoptimized · OCT-guided PCI: 14 of 467 [3.0%] vs 38 of 500 [7.6%] | 0.39 (0.21–0.72) | ||
| TVF, optimized vs nonoptimized, by imaging modality (subgroup) — Optimized vs Nonoptimized · IVUS-guided PCI: 25 of 555 [4.5%] vs 34 of 458 [7.4%] | 0.63 (0.37–1.05) | ||
| 0.20.5125Hazard ratio (log scale) |
| Outcome | Values | Estimate |
|---|---|---|
| Stent optimization achieved, by imaging modality | Overall 51.6% · OCT-guided 48.3% · IVUS-guided 54.8% |
- Stent optimization achieved, by imaging modality: OCT vs IVUS P = 0.004
- Target vessel failure (TVF), optimized vs nonoptimized, by imaging modality (subgroup): P for interaction = 0.30
Original publication
Proportion and Clinical Impact of Stent Optimization During Imaging-Guided Percutaneous Coronary Intervention. JACC Cardiovasc Interv. Published 23 April 2025. doi:10.1016/j.jcin.2025.01.436
Summarised from the published abstract; every number is checked against it