What is the clinical evidence from this study?

Study design: Cohort. Population: ST-segment elevation myocardial infarction (n=533). Intervention: Optical coherence tomography (OCT)-guided PCI vs. Intravascular ultrasound (IVUS)-guided PCI. Primary outcome: Target lesion failure (composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization) (p=0.221).

What question did this study set out to answer?

This investigation aims to compare the clinical outcomes of OCT-guided versus IVUS-guided PCI in STEMI patients.

February 1, 2024Open Access

Comparison between optical coherence tomography-guided and intravascular ultrasound-guided primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Q: What does this research mean for the field?

Optical coherence tomography-guided primary percutaneous coronary intervention (PCI) results in comparable rates of target lesion failure and overall clinical outcomes compared to intravascular ultrasound-guided PCI in patients with ST-segment elevation myocardial infarction. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

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Key result

OCT-guided PCI is linked to similar target lesion failure rates compared to IVUS-guided PCI.

P=0.221
n=533

Why the study?

To examine the clinical outcomes of optical coherence tomography (OCT)-guided PCI compared with IVUS-guided PCI in patients presenting with STEMI.

Does optical coherence tomography (OCT)-guided primary PCI improve clinical outcomes compared to intravascular ultrasound (IVUS)-guided primary PCI in patients with STEMI?

Population

533 consecutive patients who underwent primary PCI for STEMI

Comparison

OCT-guided PCI vs IVUS-guided PCI

Design

Retrospective propensity score-matched cohort study

Follow-up

Median 2.2 years

Authors

YMYuji MatsuwakiFujita Health University Hospital TMTakashi MuramatsuNihon University YOYukio OzakiBoston University

Discussion

Member takes

Implication

Comparable TLF with OCT- vs IVUS-guided PCI in STEMI; leaves open whether imaging improves outcomes vs angiography.

Key Points

This investigation aims to compare the clinical outcomes of OCT-guided versus IVUS-guided PCI in STEMI patients.
Retrospective analysis of 533 STEMI patients undergoing primary PCI from June 2016 to December 2020.
Propensity score matching used for direct comparison between OCT-guided (n=166) and IVUS-guided (n=367) interventions.
Primary endpoint was target lesion failure defined as cardiac death, target vessel MI, or target lesion revascularization.
The cumulative incidence of target lesion failure was 9.6% in the OCT group and 13.6% in the IVUS group (p=0.221).
Cardiac mortality was significantly higher in the IVUS group (8.7%) compared to the OCT group (3.6%; p=0.047).
After propensity score matching, no significant between-group differences in target lesion failure or other clinical outcomes were observed.

Study Design

Type

Cohort (n=533)

Structured PICO

Does optical coherence tomography (OCT)-guided primary PCI improve clinical outcomes compared to intravascular ultrasound (IVUS)-guided primary PCI in patients with STEMI?

Population

533 consecutive patients who underwent primary PCI for ST-segment elevation myocardial infarction, followed for a median of 2.2 years.

Exposure

Optical coherence tomography (OCT)-guided primary percutaneous coronary intervention (PCI)

Comparator

Intravascular ultrasound (IVUS)-guided primary percutaneous coronary intervention (PCI)

Outcome

Target lesion failure (TLF; defined as a composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization) at median 2.2 years follow-upcomposite

Main Result

Absolute Event Rate: 9.6% vs 13.6%

p-value: p=0.221

In patients with STEMI undergoing primary PCI, OCT guidance resulted in comparable clinical outcomes to IVUS guidance after propensity score matching, despite requiring a larger volume of contrast.

Cite This Study

Matsuwaki et al. (2024) conducted a cohort in ST-segment elevation myocardial infarction (n=533). Optical coherence tomography (OCT)-guided PCI vs. Intravascular ultrasound (IVUS)-guided PCI was evaluated on Target lesion failure (composite of cardiac death, target vessel myocardial infarction, or target lesion revascularization) (p=0.221). Optical coherence tomography-guided PCI was associated with a similar rate of target lesion failure compared to intravascular ultrasound-guided PCI (9.6% vs 13.6%; p=0.221).

synapsesocial.com/papers/6a2fa79d80b8ef8aeb5c6bd5 https://doi.org/10.20407/fmj.2023-006

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Comparison between optical coherence tomography-guided and intravascular ultrasound-guided primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Comparison between optical coherence tomography-guided and intravascular ultrasound-guided primary percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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