OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up

0480066 - ÚI 2019 RIV IE eng J - Článek v odborném periodiku
Kala, P. - Červinka, P. - Jakl, M. - Kanovský, J. - Kupec, A. - Špaček, R. - Kvasnak, M. - Poloczek, M. - Červinková, M. - Bezerra, H. - Valenta, Zdeněk - Attizzani, G. - Schnell, A. - Hong, L. - Costa, M.
OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up.
International Journal of Cardiology. Roč. 250, 1 January (2018), s. 98-103. ISSN 0167-5273. E-ISSN 1874-1754
Institucionální podpora: RVO:67985807
Klíčová slova: optical coherence tomography * OCT * primary PCI * ST-segment elevation myocardial infarction * drug-eluting stents
Obor OECD: Cardiac and Cardiovascular systems
Impakt faktor: 3.471, rok: 2018

Aims: To assess the possible merits of optical coherence tomography (OCT) guidance in primary percutaneous coronary intervention (pPCI). Methods and results: 201 patients with ST-elevation myocardial infarction (STEMI) were enrolled in this study. Patients were randomized either to pPCI alone (angio-guided group, n = 96) or to pPCI with OCT guidance (OCT-guided group, n = 105) and also either to biolimus A9 or to everolimus-eluting stent implantation. All patients were scheduled for nine months of follow-up angiography and OCT study. OCT guidance led to post-pPCI optimization in 29% of cases (59% malapposition and 41% dissections). No complications were found related to the OCT study. OCT analysis at nine months showed significantly less in-segment area of stenosis (6% [-11, 19] versus 18% [3, 33], p = 0.0002) in favor of the OCT-guided group. The rate major adverse cardiovascular events were comparable at nine months in both groups (3% in the OCT group versus 2% in the angio-guided group, p = 0.87). Conclusions: This study demonstrates the safety of OCT guidance during pPCI. The use of OCT optimized stent deployment in 1/3 of patients in this clinical scenario and significantly reduced in-segment area of stenosis at nine months of follow-up. Whether such improvements in OCT endpoints will have a positive impact on late clinical outcomes, they demand both a larger and longer-term follow-up study.
Trvalý link: http://hdl.handle.net/11104/0276062