Optical Coherence Tomography–Guided Percutaneous Coronary Intervention in ST-Segment–Elevation Myocardial Infarction: A Prospective Propensity–Matched Cohort of the Thrombectomy Versus Percutaneous Coronary Intervention Alone Trial

BACKGROUND—Patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment–elevation myocardial infarction are at increased risk for adverse events. It is unclear if image guidance by optical coherence tomography (OCT) can improve outcomes in these patients. We compared OCT-guide...

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Veröffentlicht in:Circulation. Cardiovascular interventions 2016-04, Vol.9 (4), p.e003414-e003414
Hauptverfasser: Sheth, Tej N, Kajander, Olli A, Lavi, Shahar, Bhindi, Ravinay, Cantor, Warren J, Cheema, Asim N, Stankovic, Goran, Niemelä, Kari, Natarajan, Madhu K, Shestakovska, Olga, Tittarelli, Rachel, Meeks, Brandi, Jolly, Sanjit S
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Sprache:eng
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Zusammenfassung:BACKGROUND—Patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment–elevation myocardial infarction are at increased risk for adverse events. It is unclear if image guidance by optical coherence tomography (OCT) can improve outcomes in these patients. We compared OCT-guided versus angiography-guided primary PCI for ST-segment–elevation myocardial infarction among patients in the Thrombectomy Versus PCI Alone (TOTAL) trial. METHODS AND RESULTS—Among 10 732 patients enrolled in the TOTAL trial, OCT was used for PCI guidance as a part of a prospective substudy in 214 patients. Using 2:1 propensity matching, we identified 428 patients in the trial who had PCI performed with angiography guidance alone. The primary outcome was a composite of cardiovascular death, myocardial infarction, stent thrombosis, and target-vessel revascularization at 1 year. Secondary outcomes included final in-stent angiographic minimum lumen diameter, procedure time, and contrast dose. The final in-stent angiographic minimum lumen diameter was 2.99±0.48 mm in the OCT-guided group versus 2.79±0.47 mm in the angiography-guided group (P
ISSN:1941-7640
1941-7632
DOI:10.1161/CIRCINTERVENTIONS.115.003414