Researchers conducted a multicenter randomized study involving 2008 patients undergoing coronary angioplasty (PCI). In this group, 1005 patients underwent a procedure guided by OCT, and 1003 patients by IVUS.
The average age of participants was 65 years, 21% of subjects were women, and there were no significant differences between both groups.
The primary endpoint was target-lesion failure (TLF), defined as the composite of cardiovascular death, acute myocardial infarction related to the treated vessel, or ischemia-driven target lesion revascularization (TLR), all measured at 12 months.
After one year of follow-up, there were no differences in the primary endpoint between the OCT and IVUS groups (2.5% vs. 3.1%, respectively), which showed that OCT was non-inferior to IVUS (risk difference, -0.6 percentage points; upper limit of unilateral 97.5% confidence interval, 0.97; p<0.001 for non-inferiority). This was also valid for sub-results of cardiovascular death, acute myocardial infarction related to the treated vessel, or ischemia-driven reintervention.
Additionally, researchers analyzed nephrotoxicity caused by the contrast solution used in the procedures, and there were no significant differences between both strategies.
In summary, the authors concluded that there were no differences in terms of clinical outcomes, major events, or the risk of nephrotoxicity between OCT-based and IVUS-based strategies.
Dr. Carlos Fava.
Member of the Editorial Board of SOLACI.org.
Source: Presented by Duk-Woo Park during the ESC 2023 Congress.
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