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

News | Cardiovascular Clinical Studies

April 20, 2023 — Researchers led by Northwestern University and the University of Texas at Austin (UT) have developed ...

Home April 20, 2023
Home
News | Cardiovascular Clinical Studies

April 5, 2023 — Acarix, a leader in acoustic and AI-based cardiac diagnostics, announced the release of a new study ...

Home April 05, 2023
Home
News | Cardiovascular Clinical Studies

March 29, 2023 — Irregular sleep patterns may play a role in the pathophysiologic development of cardiovascular disease ...

Home March 29, 2023
Home
News | Cardiovascular Clinical Studies

March 27, 2023 — Tenax Therapeutics, Inc., a specialty pharmaceutical company focused on identifying, developing and ...

Home March 27, 2023
Home
News | Cardiovascular Clinical Studies

March 24, 2023 — Vaxxinity, Inc., a Cape Canaveral, FL-based company pioneering the development of a new class of ...

Home March 24, 2023
Home
News | Cardiovascular Clinical Studies

March 22, 2023 — Ancora Heart, Inc., a privately-held Santa Clara, CA-based company developing a completely ...

Home March 22, 2023
Home
News | Cardiovascular Clinical Studies

March 21, 2023 — The first platform to combine real-world cardiology data from millions of people in multiple European ...

Home March 21, 2023
Home
News | Cardiovascular Clinical Studies

March 13, 2023 — BioCardia, Inc., developer of cellular and cell-derived therapeutics for the treatment of ...

Home March 13, 2023
Home
News | Cardiovascular Clinical Studies

March 8, 2023 — A unique community-based partnership, the African American Heart Study, will be conducted to measure the ...

Home March 08, 2023
Home
News | Cardiovascular Clinical Studies

March 6, 2023 — A multifaceted intervention to improve prescribing practices increased the likelihood that patients with ...

Home March 06, 2023
Home
Subscribe Now