Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: The
Do-Yoon Kang1, Jung-Min Ahn1, Sung-Cheol Yun2
1Division of Cardiology (D.-Y.K., J.-M.A., H.K., Y.C., J.L., D.-W.P., S.-J.P.), Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Circulation
|August 27, 2023
Summary
Optical coherence tomography (OCT)-guided percutaneous coronary intervention (PCI) is noninferior to intravascular ultrasound (IVUS)-guided PCI for major adverse cardiac events. This study compared OCT and IVUS in 2008 patients undergoing PCI for significant coronary artery lesions.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Imaging
Background:
- Intravascular imaging, including IVUS and OCT, improves PCI outcomes over angiography alone.
- The comparative effectiveness of OCT-guided versus IVUS-guided PCI remains unclear.
Purpose of the Study:
- To compare the clinical outcomes of OCT-guided PCI versus IVUS-guided PCI in patients with significant coronary artery lesions.
Main Methods:
- A prospective, multicenter, randomized trial assigned 2008 patients to OCT-guided or IVUS-guided PCI.
- The primary endpoint was a composite of cardiac death, target vessel MI, or ischemia-driven revascularization at 1 year.
Main Results:
- OCT-guided PCI demonstrated noninferiority to IVUS-guided PCI, with a primary endpoint event rate of 2.5% vs. 3.1% (P<0.001 for noninferiority).
- Major procedural complications were lower in the OCT group (2.2% vs. 3.7%, P=0.047).
- Contrast-induced nephropathy rates were similar between groups.
Conclusions:
- OCT-guided PCI is a safe and effective alternative to IVUS-guided PCI for significant coronary artery lesions.
- The study highlights the noninferiority of OCT in improving clinical outcomes post-PCI.
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