Angiography alone versus angiography plus optical coherence tomography to guide decision-making during percutaneous coronary intervention: The Centro per la Lotta contro l'Infarto-Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) study

Francesco Burzotta, Carlo Trani, Francesco Prati, Italo Porto, Michele Occhipinti, Alessio La Manna, Corrado Tamburino, Fabrizio Imola, Laura Materia, Alberto Cremonesi, Mario Albertucci

Risultato della ricerca: Contributo in rivistaArticolo in rivista

236 Citazioni (Scopus)

Abstract

Aims: Angiographic guidance for percutaneous coronary intervention (PCI) has substantial limitations. The superior spatial resolution of optical coherence tomography (OCT) could translate into meaningful clinical benefits. We aimed to compare angiographic guidance alone versus angiographic plus OCT guidance for PCI. Methods and results: Patients undergoing PCI with angiographic plus OCT guidance (OCT group) were compared with matched patients undergoing PCI with angiographic only guidance (Angio group) within 30 days. The primary endpoint was the one-year rate of cardiac death or myocardial infarction (MI). A total of 670 patients were included, 335 in the OCT group and 335 in the Angio group. OCT disclosed adverse features requiring further interventions in 34.7%. Unadjusted analyses showed that the OCT group had a significantly lower one-year risk of cardiac death (1.2% vs. 4.5%, p=0.010), cardiac death or MI (6.6% vs. 13.0%, p=0.006), and the composite of cardiac death, MI, or repeat revascularisation (9.6% vs. 14.8%, p=0.044). Angiographic plus OCT guidance was associated with a significantly lower risk of cardiac death or MI even at extensive multivariable analysis adjusting for baseline and procedural differences between the groups (OR=0.49 [0.25-0.96], p=0.037) and at propensity-score adjusted analyses. Conclusions: This observational study, the first ever formally to appraise OCT guidance for PCI decision-making, suggests that the use of OCT can improve clinical outcomes of patients undergoing PCI. © Europa Digital & Publishing 2012. All rights reserved.
Lingua originaleEnglish
pagine (da-a)823-829
Numero di pagine7
RivistaEuroIntervention
Volume8
DOI
Stato di pubblicazionePubblicato - 2012

Keywords

  • Aged
  • Angiography
  • Chi-Square Distribution
  • Coronary Angiography
  • Coronary Artery Disease
  • Coronary Vessels
  • Coronary artery disease
  • Female
  • Humans
  • Italy
  • Logistic Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Myocardial Infarction
  • Odds Ratio
  • Optical coherence tomography
  • Percutaneous Coronary Intervention
  • Percutaneous transluminal coronary angioplasty
  • Predictive Value of Tests
  • Propensity Score
  • Proportional Hazards Models
  • Prosthesis Design
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Stent
  • Stents
  • Time Factors
  • Tomography, Optical Coherence
  • Treatment Outcome

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