Key result
OCT-guided PCI shows no significant benefit over angiography-guided PCI for 6-month MACE.
Why the study?
Optical coherence tomography is considered superior to coronary angiography, but it is not widely used and data evaluating its efficacy and safety are limited in India.
Does OCT-guided PCI reduce major adverse cardiac events at 6 months compared to angiography-guided PCI in all-comer patients undergoing PCI?
Observational (n=434)
No
Does OCT-guided PCI reduce major adverse cardiac events at 6 months compared to angiography-guided PCI in all-comer patients undergoing PCI?
Absolute Event Rate: 6.9% vs 9.7%
p-value: p=0.296
In a retrospective propensity-matched cohort, OCT-guided PCI did not significantly reduce MACE at 6 months compared to angiography-guided PCI.
No significant MACE reduction with OCT-guided PCI; leaves open whether randomized trials confirm benefit in all-comers.
Objective: Optical coherence tomography (OCT) is considered superior to coronary angiography (CA).However, OCT is not widely used, and data are limited in India.In the present study, the efficacy and safety of OCT for guiding percutaneous coronary intervention (PCI) in all-comer patients were evaluated and compared with those of CA. Materials and Methods:In this retrospective study, the data associated with 434 patients who underwent PCI between December 2018 and June 2020 were analyzed.The primary endpoint was major adverse cardiac events (MACEs) at 6 months.Results: The patients were divided into OCT-guided and angiography-guided PCI groups (217 in each group) after propensity matching.The OCT-guided PCI group had a significantly larger proportion of patients with unstable angina (55.7% vs. 43.3%,p=0.009) and non-STelevation myocardial infarction (NSTEMI; 17.5% vs. 10.0%,p=0.02) compared with the angiography-guided PCI group, and the proportion of patients with STEMI was significantly lower in the OCT-guided PCI group than in the angiography-guided PCI group (23.5% vs. 41.5%,p=0.00005).The OCT-guided PCI group had a lower incidence of MACEs at 6 months than the angiography-guided PCI group but without statistical significance (6.9% vs. 9.7%, p=0.296).Incidences of target lesion failure, target vessel myocardial infarction, in-stent restenosis, or stent thrombosis did not occur in either group.On post-PCI OCT, stent underexpansion, tissue prolapse, stent edge dissection, and stent malapposition were observed in 28.5%, 10%, 4.1%, and 3.7% of the cases, respectively.Conclusion: When comparing OCT-guided PCI with angiography-guided PCI, OCT-guided PCI showed slightly superior clinical outcomes at 6 months, although the differences were not statistically significant.
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Roy et al. (2024) conducted an observational in Coronary artery disease requiring percutaneous coronary intervention (n=434). Optical coherence tomography (OCT)-guided PCI vs. Angiography-guided PCI was evaluated on Major adverse cardiac events (MACEs) at 6 months (p=0.296). Optical coherence tomography-guided PCI showed a lower incidence of major adverse cardiac events at 6 months compared to angiography-guided PCI, though the difference was not statistically significant (6.9% vs. 9.7%, p=0.296).
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