Feature | September 26, 2014

OCT-guided STEMI Interventions Show Fewer Uncovered Stent Struts, Similar Outcomes to Non-OCT PCI

Results of OCT STEMI Trial Reported at TCT 2014

OCT
September 26, 2014 — The first randomized trial to examine serial optical coherence tomography (OCT) in primary percutaneous coronary intervention (PCI) was reported at the Transcatheter Cardiovascular Therapeutics (TCT) scientific symposium last week.  The trial showed similar outcomes in to a control group that did not use OCT. The nine-month follow up data showed significantly smaller area stenosis and a trend toward fewer uncovered struts in the OCT guided group.  
 
OCT uses light emitted from an intravascular catheter to capture high-resolution cross sectional imaging from within coronary arteries. OCT STEMI is the first randomized multicenter study to examine routine use of OCT guidance during stent implantation in patients with ST-elevation myocardial infarction (STEMI), the most serious form of a heart attack) undergoing primary PCI. The primary endpoints were the rate of major adverse coronary events (MACE) including death, myocardial infarction, and ischemia-driven target lesion revascularization at 30 days and nine months. The number of uncovered struts, area stenosis and minimal lumen diameter were assessed by OCT after nine months. 
 
A total of 201 patients were enrolled in the study and pre-treated with aspirin, heparin and clopidogrel. After radial diagnostic angiography, patients were randomly assigned to either primary PCI alone (n=96) or to primary PCI with OCT guidance (n=105). Drug-eluting stents (DES) were used in this trial and dual antiplatelet therapy was recommended for 12 months in both groups. 
 
The rate of MACE was very low and comparable at 30 days and nine-month follow up in both groups. The rates of stent thrombosis, late lumen loss and binary restenosis were also similarly low in both groups. Nine-month OCT analysis revealed significantly smaller area stenosis (p=0.001) and a trend toward fewer uncovered struts (p=0.07) in the OCT guided group.  
 
Baseline demographic and procedural characteristics were well balanced in both groups. Based on the OCT data, more stents were used in the OCT group (likely based upon the intraprocedural OCT findings), and fluoroscopy time was significantly longer in the OCT group. 
 
“The OCT STEMI trial demonstrates the potential merit of OCT guidance during drug-eluting stent implantation in primary PCI,” said lead investigator Pavel Cervinka, Ph.D., M.D. Cervinka is a professor from Faculty Hospital Hradee Králové and Masaryk Hospital in the Czech Republic. “The study also indicates that the procedure is safe for STEMI patients, and larger randomized trials with longer-term follow-up are warranted.”
 
The OCT STEMI trial was funded by grants from Boston Scientific and A Care. Cervinka reported no disclosures.  
 
For more information: www.crf.org, www.tctconference.com
 

Related Content

Biotronik Studies Demonstrate Efficacy of Minimizing Metal Burden in SFA Therapy
News | Stents Bare Metal| September 22, 2017
Physicians demonstrated that reducing metal burden in superficial femoral artery (SFA) therapy could effectively reduce...
Edwards Inspiris Resilia Valve Receives FDA Approval
News | Heart Valve Technology| September 21, 2017
Edwards Lifesciences Corp. recently received U.S. Food and Drug Administration (FDA) approval for its Inspiris Resilia...
MyoKardia Presents Additional Positive Data From Phase 2 PIONEER-HCM Study at HFSA 2017
News | Heart Failure| September 21, 2017
MyoKardia Inc. announced that additional positive data from the first patient cohort of its Phase 2 PIONEER-HCM study...
Tryton Side Branch Stent Recognized With Premier Technology Breakthrough Award
News | Stents Bifurcation| September 21, 2017
September 21, 2017 — Cardinal Health and Tryton Medical Inc.
DISRUPT BTK Study Shows Positive Results With Lithoplasty in Calcified Lesions Below the Knee
News | Peripheral Artery Disease (PAD)| September 20, 2017
Shockwave Medical reported positive results from the DISRUPT BTK Study, which were presented at the annual...
Corindus Announces First Patient Enrolled in PRECISION GRX Registry
News | Robotic Systems| September 18, 2017
September 18, 2017 — Corindus Vascular Robotics Inc.
Two-Year ILLUMENATE Trial Data Demonstrate Efficacy of Stellarex Drug-Coated Balloon
News | Drug-Eluting Balloons| September 18, 2017
Philips announced the two-year results from the ILLUMENATE European randomized clinical trial (EU RCT) demonstrating...
Sentinel Cerebral Protection System Significantly Reduces Stroke and Mortality in TAVR
News | Embolic Protection Devices| September 18, 2017
September 18, 2017 – Claret Medical announced publication of a new study in the...
Fysicon Receives FDA Approval for QMAPP Hemodynamic Monitoring System
Technology | Hemodynamic Monitoring Systems| September 18, 2017
Fysicon announced that it has been granted 510(k) clearance by the U.S. Food and Drug Administration (FDA) for its...
Marijuana Associated With Three-Fold Risk of Death From Hypertension
News | Hypertension| September 14, 2017
Marijuana use is associated with a three-fold risk of death from hypertension, according to research published recently...
Overlay Init