OCT guidance during stent implantation in primary PCI: A
randomized multicenter study with nine months of optical
coherence tomography follow-up

J 2018

OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up

KALA, Petr, P. CERVINKA, M. JAKL, Jan KAŇOVSKÝ, A. KUPEC et. al.

Basic information

Original name

OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up

Authors

KALA, Petr (203 Czech Republic, belonging to the institution), P. CERVINKA (203 Czech Republic, guarantor), M. JAKL (203 Czech Republic), Jan KAŇOVSKÝ (203 Czech Republic, belonging to the institution), A. KUPEC (203 Czech Republic), R. SPACEK (203 Czech Republic), M. KVASNAK (203 Czech Republic), Martin POLOCZEK (203 Czech Republic), M. CERVINKOVA (203 Czech Republic), H. BEZERRA (840 United States of America), Z. VALENTA (203 Czech Republic), G.F. ATTIZZANI (840 United States of America), A. SCHNELL (840 United States of America), L. HONG (840 United States of America) and M.A. COSTA (840 United States of America)

Edition

International Journal of Cardiology, Clare (Ireland), Elsevier Ireland Ltd. 2018, 0167-5273

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30201 Cardiac and Cardiovascular systems

Country of publisher

Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

Impact factor

Impact factor: 3.471

RIV identification code

RIV/00216224:14110/18:00102131

Organization unit

Faculty of Medicine

DOI

http://dx.doi.org/10.1016/j.ijcard.2017.10.059

UT WoS

000415822100021

Keywords in English

Optical coherence tomography; OCT; Primary PCI; ST-segment elevation myocardial infarction; Drug-eluting stents

Abstract

V originále

Aims: To assess the possible merits of optical coherence tomography (OCT) guidance in primary percutaneous coronary intervention (pPCI). Methods and results: 201 patients with ST-elevation myocardial infarction (STEMI) were enrolled in this study. Patients were randomized either to pPCI alone (angio-guided group, n = 96) or to pPCI with OCT guidance (OCT-guided group, n = 105) and also either to biolimus A9 or to everolimus-eluting stent implantation. All patients were scheduled for nine months of follow-up angiography and OCT study. OCT guidance led to post-pPCI optimization in 29% of cases (59% malapposition and 41% dissections). No complications were found related to the OCT study. OCT analysis at ninemonths showed significantly less in-segment area of stenosis (6% [-11, 19] versus 18% [3, 33]; p = 0.0002) in favor of the OCT-guided group. The rate major adverse cardiovascular events were comparable at nine months in both groups (3% in the OCT group versus 2% in the angio-guided group; p = 0.87). Conclusions: This study demonstrates the safety of OCT guidance during pPCI. The use of OCT optimized stent deployment in 1/3 of patients in this clinical scenario and significantly reduced in-segment area of stenosis at nine months of follow-up. Whether such improvements in OCT endpoints will have a positive impact on late clinical outcomes, they demand both a larger and longer-term follow-up study. (C) 2017 Elsevier B.V. All rights reserved.

Citovat

KALA, Petr, P. CERVINKA, M. JAKL, Jan KAŇOVSKÝ, A. KUPEC, R. SPACEK, M. KVASNAK, Martin POLOCZEK, M. CERVINKOVA, H. BEZERRA, Z. VALENTA, G.F. ATTIZZANI, A. SCHNELL, L. HONG and M.A. COSTA. OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up. International Journal of Cardiology. Clare (Ireland): Elsevier Ireland Ltd., 2018, vol. 250, JAN 1 2018, p. 98-103. ISSN 0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2017.10.059.

@article{1398905,
   author = {Kala, Petr and Cervinka, P. and Jakl, M. and Kaňovský, Jan and Kupec, A. and Spacek, R. and Kvasnak, M. and Poloczek, Martin and Cervinkova, M. and Bezerra, H. and Valenta, Z. and Attizzani, G.F. and Schnell, A. and Hong, L. and Costa, M.A.},
   article_location = {Clare (Ireland)},
   article_number = {JAN 1 2018},
   doi = {http://dx.doi.org/10.1016/j.ijcard.2017.10.059},
   keywords = {Optical coherence tomography; OCT; Primary PCI; ST-segment elevation myocardial infarction; Drug-eluting stents},
   language = {eng},
   issn = {0167-5273},
   journal = {International Journal of Cardiology},
   title = {OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up},
   volume = {250},
   year = {2018}
}

TY  - JOUR
ID  - 1398905
AU  - Kala, Petr - Cervinka, P. - Jakl, M. - Kaňovský, Jan - Kupec, A. - Spacek, R. - Kvasnak, M. - Poloczek, Martin - Cervinkova, M. - Bezerra, H. - Valenta, Z. - Attizzani, G.F. - Schnell, A. - Hong, L. - Costa, M.A.
PY  - 2018
TI  - OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up
JF  - International Journal of Cardiology
VL  - 250
IS  - JAN 1 2018
SP  - 98-103
EP  - 98-103
PB  - Elsevier Ireland Ltd.
SN  - 01675273
KW  - Optical coherence tomography
KW  - OCT
KW  - Primary PCI
KW  - ST-segment elevation myocardial infarction
KW  - Drug-eluting stents
N2  - Aims: To assess the possible merits of optical coherence tomography (OCT) guidance in primary percutaneous coronary intervention (pPCI). Methods and results: 201 patients with ST-elevation myocardial infarction (STEMI) were enrolled in this study. Patients were randomized either to pPCI alone (angio-guided group, n = 96) or to pPCI with OCT guidance (OCT-guided group, n = 105) and also either to biolimus A9 or to everolimus-eluting stent implantation. All patients were scheduled for nine months of follow-up angiography and OCT study. OCT guidance led to post-pPCI optimization in 29% of cases (59% malapposition and 41% dissections). No complications were found related to the OCT study. OCT analysis at ninemonths showed significantly less in-segment area of stenosis (6% [-11, 19] versus 18% [3, 33]; p = 0.0002) in favor of the OCT-guided group. The rate major adverse cardiovascular events were comparable at nine months in both groups (3% in the OCT group versus 2% in the angio-guided group; p = 0.87). Conclusions: This study demonstrates the safety of OCT guidance during pPCI. The use of OCT optimized stent deployment in 1/3 of patients in this clinical scenario and significantly reduced in-segment area of stenosis at nine months of follow-up. Whether such improvements in OCT endpoints will have a positive impact on late clinical outcomes, they demand both a larger and longer-term follow-up study. (C) 2017 Elsevier B.V. All rights reserved.
ER  -

KALA, Petr, P. CERVINKA, M. JAKL, Jan KAŇOVSKÝ, A. KUPEC, R. SPACEK, M. KVASNAK, Martin POLOCZEK, M. CERVINKOVA, H. BEZERRA, Z. VALENTA, G.F. ATTIZZANI, A. SCHNELL, L. HONG and M.A. COSTA. OCT guidance during stent implantation in primary PCI: A randomized multicenter study with nine months of optical coherence tomography follow-up. \textit{International Journal of Cardiology}. Clare (Ireland): Elsevier Ireland Ltd., 2018, vol.~250, JAN 1 2018, p.~98-103. ISSN~0167-5273. Available from: https://dx.doi.org/10.1016/j.ijcard.2017.10.059.

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