Portal de Periódicos da CAPES

Clinical Impact of OCT Findings During PCI

2015; Elsevier BV; Volume: 8; Issue: 11 Linguagem: Inglês

10.1016/j.jcmg.2015.08.013

1936-878X

Francesco Prati, Enrico Romagnoli, Francesco Burzotta, Ugo Limbruno, Laura Gatto, Alessio La Manna, Francesco Versaci, Valeria Marco, Luca Di Vito, Fabrizio Imola, Giulia Paoletti, Carlo Trani, Corrado Tamburino, Luigi Tavazzi, Gary S. Mintz,

Peripheral Artery Disease Management

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. METHODSIn 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 < 0.001).In particular, in-stent minimum lumen area 200 mm at the distal stent edge (HR: 2.54; p ¼ 0.004), and reference lumen area <4.5 mm 2 at either distal (HR: 4.65; p < 0.001) or proximal (HR: 5.73; p < 0.001) stent edges were independent predictors of MACE.Conversely, in-stent minimum lumen area/mean reference lumen area 200 mm (HR: 1.15; p ¼ 0.52), intrastent plaque/thrombus protrusion >500 mm (HR: 1.00; p ¼ 0.99), and dissection >200 mm at the proximal stent edge (HR: 0.83; p ¼ 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 < 0.001).CONCLUSIONS Suboptimal stent deployment defined according to specific quantitative OCT criteria was associated with an increased risk of MACE during follow-up.(