Clinical Impact of OCT Findings During PCI
| Autor: | Laura Gatto, Alessio La Manna, Corrado Tamburino, Enrico Romagnoli, Ugo Limbruno, Giulia Paoletti, Luigi Tavazzi, Francesco Versaci, Fabrizio Imola, Francesco Prati, Luca Di Vito, Francesco Burzotta, Carlo Trani, Gary S. Mintz, Valeria Marco |
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| Rok vydání: | 2015 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Percutaneous coronary intervention Stent Context (language use) medicine.disease Coronary artery disease Coronary thrombosis Radiology Nuclear Medicine and imaging Conventional PCI medicine Radiology Nuclear Medicine and imaging cardiovascular diseases Myocardial infarction Radiology Cardiology and Cardiovascular Medicine business Mace |
| Zdroj: | JACC: Cardiovascular Imaging. 8:1297-1305 |
| ISSN: | 1936-878X |
| DOI: | 10.1016/j.jcmg.2015.08.013 |
| Popis: | Objectives The goal of this study was to assess the clinical impact of optical coherence tomography (OCT) findings during percutaneous coronary intervention (PCI). Background OCT provides unprecedented high-definition visualization of plaque/stent structures during PCI; however, the impact of OCT findings on outcome remains undefined. Methods In the context of the multicenter CLI-OPCI (Centro per la Lotta contro l’Infarto–Optimisation of Percutaneous Coronary Intervention) registry, we retrospectively analyzed patients undergoing end-procedural OCT assessment and compared the findings with clinical outcomes. Results A total of 1,002 lesions (832 patients) were assessed. Appropriate OCT assessment was obtained in 98.2% of cases and revealed suboptimal stent implantation in 31.0% of lesions, with increased incidence in patients experiencing major adverse cardiac events (MACE) during follow-up (59.2% vs. 26.9%; p 200 μm at the distal stent edge (HR: 2.54; p = 0.004), and reference lumen area 200 μm (HR: 1.15; p = 0.52), intrastent plaque/thrombus protrusion >500 μm (HR: 1.00; p = 0.99), and dissection >200 μm at the proximal stent edge (HR: 0.83; p = 0.65) were not associated with worse outcomes. Using multivariable Cox hazard analysis, the presence of at least 1 significant criterion for suboptimal OCT stent deployment was confirmed as an independent predictor of MACE (HR: 3.53; 95% confidence interval: 2.2 to 5.8; p Conclusions Suboptimal stent deployment defined according to specific quantitative OCT criteria was associated with an increased risk of MACE during follow-up. |
| Databáze: | OpenAIRE |
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