Author + information
- Poonam Velagapudia,b,
- Mohit Turagama,b,
- Herbert Aronowa,b,
- Sahil Kheraa,b,
- Dhaval Koltea,b and
- J. Abbotta,b
Background: Optical coherence tomography (OCT)-guided PCI can safely be performed in patients with stable angina and acute coronary syndromes (ACS). Whether OCT-guided PCI improves clinical outcomes when compared with angiography-guided (AG)-PCI is unclear. We performed a meta-analysis of trials comparing AG- vs. OCT-guided PCI.
Methods: A comprehensive literature search including studies comparing OCT- vs. AG-guided PCI, indexed through October 10, 2016 in Pubmed, Ebsco and Google Scholar, was performed. Three eligible studies (1 randomized, 1 prospective cohort, 1 retrospective) consisting of 1,552 patients (OCT n=669; AG n=883) with stable angina or ACS were identified. Follow-up ranged from 6-12 months.
Results: A low degree of heterogeneity was observed across studies (Cochrane q-statistic [I2] =0 – 20%). When comparing patients who underwent OCT- vs. AG-guided PCI (Figures 1-4), no differences were observed in all-cause mortality (HR 0.60, 95% CI [0.17-2.18]), myocardial infarction (HR 0.67 95% CI [0.4-1.13]), stent thrombosis (HR 1.23, 95% CI [0.38-3.91]) or target lesion/vessel revascularization (HR 0.99, 95% CI [0.57-1.69]), but cardiac mortality [HR 0.36, 95% CI (0.16-0.78), p=0.01] occurred significantly less often with the former strategy.
Conclusions: OCT-guided PCI was associated with significantly lower cardiac mortality with no difference in all-cause mortality, MI, ST or TLR/TVR when compared with AG-PCI.
Poster Hall, Hall C
Friday, March 17, 2017, 3:45 p.m.-4:30 p.m.
Session Title: Coronary Intervention in Interventional Cardiology: Advanced Device Use
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1155-154
- 2017 American College of Cardiology Foundation