Key result
Stent boost subtract imaging accurately identified stent underexpansion with 80% sensitivity and 96% specificity compared to optical coherence tomography.
Why the study?
To evaluate the effect of stent boost subtract (SBS) imaging on stent underexpansion during PCI in patients with acute STEMI using optical coherence tomography (OCT).
Does stent boost subtract (SBS) imaging improve the detection of stent underexpansion and reduce MACE compared to coronary angiography in STEMI patients undergoing PCI?
Observational (n=138)
No
Does stent boost subtract (SBS) imaging improve the detection of stent underexpansion and reduce MACE compared to coronary angiography in STEMI patients undergoing PCI?
Effect estimate: Kappa 0.789
Absolute Event Rate: 24.8% vs 27.2%
p-value: p=<0.001
Stent boost subtract imaging is a rapid, economical tool that accurately identifies stent underexpansion and may improve clinical outcomes compared to standard angiography in STEMI patients.
SBS imaging may support intraprocedural underexpansion assessment; leaves open whether it reduces MACE versus angiography in STEMI PCI.
BACKGROUND: To evaluate the effect of stent boost subtract (SBS) imaging on stent underexpansion during percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) by optical coherence tomography (OCT). METHODS: One hundred thirty-eight STEMI patients who underwent drug-eluting stent (DES) implantation were prospectively recruited and divided into the SBS group (69 cases) and the CAG group (69 cases) according to whether SBS was used to guide PCI. Finally, OCT was performed on all enrolled patients, and the OCT results were used as the gold standard to evaluate the impact of standard SBS technology on stent underexpansion immediately after DES implantation. RESULTS: SBS identified 51 patients (24%) with stent underexpansion while OCT identified 56 patients (27.2%). SBS has a sensitivity of 80%, a specificity of 96%, a positive predictive value of 88%, and a negative predictive value of 93% for identifying stent underexpansion. CONCLUSION: Compared with OCT, SBS technology is a rapid stent imaging evaluation method that can accurately quantify the stent expansion level and is time-saving and economical.
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Duan et al. (2022) conducted an observational in ST-segment elevation myocardial infarction (STEMI) (n=138). Stent boost subtract (SBS) imaging vs. Optical coherence tomography (OCT) was evaluated on Identification of stent underexpansion (Kappa 0.789, p=<0.001). Stent boost subtract imaging accurately identified stent underexpansion with 80% sensitivity and 96% specificity compared to optical coherence tomography.
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