Optical Coherence Tomography-Guided or Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: The OCTIVUS Randomized Clinical Trial
- Authors
- Kang, Do-Yoon; Ahn, Jung-Min; Yun, Sung-Cheol; Hur, Seung-Ho; Cho, Yun-Kyeong; Lee, Cheol Hyun; Hong, Soon Jun; Lim, Subin; Kim, Sang-Wook; Won, Hoyoun; Oh, Jun-Hyok; Choe, Jeong Cheon; Hong, Young Joon; Yoon, Yong-Hoon; Kim, Hoyun; Choi, Yeonwoo; Lee, Jinho; Yoon, Young Won; Kim, Soo-Joong; Bae, Jang-Ho; Park, Duk-Woo; Park, Seung-Jung
- Issue Date
- Oct-2023
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- cardiac imaging techniques; percutaneous coronary intervention; tomography, optical coherence; ultrasonography, interventional
- Citation
- Circulation, v.148, no.16, pp 1195 - 1206
- Pages
- 12
- Indexed
- SCIE
SCOPUS
- Journal Title
- Circulation
- Volume
- 148
- Number
- 16
- Start Page
- 1195
- End Page
- 1206
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/64342
- DOI
- 10.1161/CIRCULATIONAHA.123.066429
- ISSN
- 0009-7322
1524-4539
- Abstract
- BACKGROUND:Intravascular imaging-guided percutaneous coronary intervention (PCI) with intravascular ultrasound (IVUS) or optical coherence tomography (OCT) showed superior clinical outcomes compared with angiography-guided PCI. However, the comparative effectiveness of OCT-guided and IVUS-guided PCI regarding clinical outcomes is unknown.METHODS:In this prospective, multicenter, open-label, pragmatic trial, we randomly assigned 2008 patients with significant coronary artery lesions undergoing PCI in a 1:1 ratio to undergo either an OCT-guided or IVUS-guided PCI. The primary end point was a composite of death from cardiac causes, target vessel-related myocardial infarction, or ischemia-driven target-vessel revascularization at 1 year, which was powered for noninferiority of the OCT group compared with the IVUS group. Safety outcomes were also assessed.RESULTS:At 1 year, primary end point events occurred in 25 of 1005 patients (Kaplan-Meier estimate, 2.5%) in the OCT group and in 31 of 1003 patients (Kaplan-Meier estimate, 3.1%) in the IVUS group (absolute difference, -0.6 percentage points; upper boundary of one-sided 97.5% CI, 0.97 percentage points; P<0.001 for noninferiority). The incidence of contrast-induced nephropathy was similar (14 patients [1.4%] in the OCT group versus 15 patients [1.5%] in the IVUS group; P=0.85). The incidence of major procedural complications was lower in the OCT group than in the IVUS group (22 [2.2%] versus 37 [3.7%]; P=0.047), although imaging procedure-related complications were not observed.CONCLUSIONS:In patients with significant coronary artery lesions, OCT-guided PCI was noninferior to IVUS-guided PCI with respect to the incidence of a composite of death from cardiac causes, target vessel-related myocardial infarction, or ischemia-driven target-vessel revascularization at 1 year. The selected study population and lower-than-expected event rates should be considered in interpreting the trial.REGISTRATION:URL: https://www.clinicaltrials.gov; Unique number: NCT03394079.
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Collections - 2. Clinical Science > Department of Cardiology > 1. Journal Articles
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