Portal de Periódicos da CAPES

Long-term consequences of optical coherence tomography findings during percutaneous coronary intervention: the Centro Per La Lotta Contro L’infarto – Optimization Of Percutaneous Coronary Intervention (CLI-OPCI) LATE study

2018; European Association of Percutaneous Cardiovascular Interventions; Volume: 14; Issue: 4 Linguagem: Inglês

10.4244/eij-d-17-01111

1969-6213

Francesco Prati, Enrico Romagnoli, Alessio La Manna, Francesco Burzotta, Laura Gatto, Valeria Marco, Massimo Fineschi, Franco Fabbiocchi, Francesco Versaci, Carlo Trani, Corrado Tamburino, Fernándo Alfonso, Gary S. Mintz,

Antiplatelet Therapy and Cardiovascular Diseases

Aims:The role of intraprocedural optical coherence tomography (OCT) on the long-term clinical outcome of percutaneous coronary interventions (PCI) remains undefined.The aim of the present study was to evaluate the impact of quantitative OCT-defined suboptimal stent implantation at long-term follow-up. Methods and results:In the context of the multicentre Centro per la Lotta contro l'Infarto -Optimisation of Percutaneous Coronary Intervention (CLI-OPCI) registry, we compared the long-term PCI outcome of 1,211 patients from 13 independent OCT-experienced centres according to end-procedural OCT findings.OCT assessment revealed suboptimal stent implantation in 30.9% of lesions, with an increased prevalence in patients experiencing device-oriented cardiovascular events (DoCE) (52.8% vs. 28.0%,p<0.001).At a median follow-up of 833 (interquartile range 415-1,447) days, in-stent minimum lumen area (MLA) <4.5 mm 2 (HR 1.82, p 200 µm (HR 2.03, p=0.004), and significant reference vessel plaque and lumen area <4.5 mm 2 at either the distal (HR 5.22, p<0.001) or proximal (HR 5.67, p<0.001) stent edges were independent predictors of device failure.Conversely, in-stent MLA/mean reference lumen area <70%, acute stent malapposition, and intra-stent plaque/thrombus protrusion were not associated with worse outcomes.Using multivariable Cox hazard analysis, the presence of at least one of the significant criteria for suboptimal OCT stent deployment was confirmed as an independent predictor of DoCE (HR 1.92, p=0.001).Conclusions: Suboptimal stent deployment, defined according to specific quantitative OCT criteria, was confirmed as an independent outcome predictor at long-term follow-up.