Coronary disease & ACS

Stenting Technique and Clinical Outcome in True Bifurcation Percutaneous Coronary Intervention (PCI): Insights From the OCTOBER Trial

JACC Cardiovasc IntervPublished Post hoc analysis of the OCTOBER randomised trial

Primary result · MACE (as-treated)Result — go to the resultAdjusted hazard ratio 1.53 95% CI 1.04–2.27

Authors' conclusion

Clinical indication, LMCA bifurcation, and SB disease severity predicted 2-stent PCI. MACE did not differ according to planned strategy, whereas actual 2-stent PCI had higher MACE rates, likely reflecting a higher burden of complexity. The lowest event rates were observed with OCT-guided 1-stent PCI.

Study context

Population
Patients with true coronary bifurcation lesions treated with PCI
Participants
1,201 patients
Comparison
1-stent vs 2-stent technique in true bifurcation PCI
Primary endpoint
MACE
Follow-up
2 years
Methodological detailsas-treated analysis, multivariable Cox regression
  • As-treated analysis
  • Multivariable Cox regression

Primary result

MACE (as-treated)

Adjusted hazard ratio

1.53

95% CI 1.04–2.27

By group

2-stentvs 1-stent
adjusted HR 1.53 (95% CI 1.04–2.27)

As reported in the abstract

Further findings

OutcomeHR (95% CI)
MACE with DK-crush: angiography-vs OCT-guided2.42 (1.12–5.24)

Major adverse cardiac events (MACE) by planned strategy

No significant difference in MACE

Predictors of 2-stent use

Acute clinical presentation, adjusted OR
1.73 (95% CI 1.33-2.25)
Left main coronary artery (LMCA) bifurcation, adjusted OR
2.04 (95% CI 1.38-3.03)
Side branch (SB) lesion length, adjusted OR per mm
1.06 (95% CI 1.03-1.09)
SB diameter stenosis, adjusted OR per 1%
1.04 (95% CI 1.03-1.05)

Original publication

Stenting Technique and Clinical Outcome in True Bifurcation PCI: Insights From the OCTOBER Trial. JACC Cardiovasc Interv. Published 28 September 2026. doi:10.1016/j.jcin.2026.06.027

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