Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE‐CARDIOGROUP IV and USZ registry |
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| Authors: | Mario Iannaccone MD Antonio H. Frangieh MD Giampaolo Niccoli MD Fabrizio Ugo MD Giacomo Boccuzzi MD Maurizio Bertaina MD Massimo Mancone MD Antonio Montefusco MD Nicolas Amabile MD Gennaro Sardella MD Pascal Motreff MD Konstantinos Toutouzas MD Francesco Colombo MD Roberto Garbo MD Giuseppe Biondi‐Zoccai Corrado Tamburino Pierluigi Omedè MD Claudio Moretti MD Maurizio D'amico MD Geraud Souteyrand MD Pascal Meieir MD Thomas F. Lüscher Fiorenzo Gaita Christian Templin |
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| Affiliation: | 1. “Città della Scienza e della Salute,” Department of Cardiology, University of Turin, Turin, ItalyMario Iannaccone and Fabrizio D'Ascenzo contributed equally to this work.;2. Department of Cardiology, Zurich University Hospital, Zurich, Switzerland;3. Division of Cardiology, Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy;4. Department of Cardiology, “S.G. Bosco Hospital,”, Turin, Italy;5. “Città della Scienza e della Salute,” Department of Cardiology, University of Turin, Turin, Italy;6. Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, “Sapienza” University of Rome, Rome, Italy;7. Cardiology Department, Institut Mutualiste Montsouris, Paris, France;8. Cardiology Department, CHU Clermont‐Ferrand, Clermont‐Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University, Clermont‐Ferrand, France;9. First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece;10. Department of Medico‐Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy;11. Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy and University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland;12. Division of Cardiology, Cardio‐thoracic‐vascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy;13. Division of Cardiology, University of Geneva, Geneva, Switzerland |
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| Abstract: | Aim. To determine the potential clinical impact of OCT (Optical Coherence Tomography) during primary percutaneous coronary intervention in patients presenting with ACS (Acute Coronary Syndrome). Methods and Results. FORMIDABLE is a multicentre retrospective registry enrolling all patients presenting with ACS and treated with an OCT‐guided approach, while the USZ registry enrolled patients treated with a standard angiography guided approach. Multivariate adjustment was performed via a propensity score matching. The number stents useds was the primary outcome, while the incidence of MACE (a composite of death, myocardial infarction, target vessel revascularization, and stent thrombosis) was the secondary endpoint. A total of 285 patients OCT‐guided and 1,547 angiography guided patients were enrolled, resulting in 270 for each cohort after propensity score with matching. Two stents were used in 12% versus 34%; 3 stents in 8% versus 38% of the patients (P < 0.001). After a follow up of 700 days (450–890), there was no difference in myocardial infarction (6% vs. 6%, P = 0.86), while MACE (11% vs. 16%, P = 0.06), target vessel revascularization (2% vs. 4%, P = 0.15) and stent thrombosis rates (0% vs. 2.7%, P = 0.26) were numerically lower for the OCT‐guided cohort but none of these endpoints did reach statistical significance. Conclusions. An OCT‐guided approach reduced the number of stents used, number of patients treated with more than one stent, while there was no statistically significant difference in clinical endpoints while most of them were numerically lower, including stent thrombosis rates. © 2016 Wiley Periodicals, Inc. |
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| Keywords: | optical coherence tomography acute coronary syndrome drug eluting stent |
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