MedElevator
Войти в исследования Optical coherence tomography-guided stent optimization and clinical outcomes in all-comer patients with ST-elevation myocardial infarction.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Yonetsu Taishi, Mizukami Takuya, Yamamoto Myong Hwa, Shishido Koki, Saito Shigeru, Kobayashi Nobuaki, Takano Masamichi, Usui Eisuke, Kakuta Tsunekazu, Oishi Yosuke, Nishikura Tenjin, Minami Yoshiyasu, Ako Junya, Okabe Toshitaka, Ochiai Masahiko, Mitomo Satoru, Nakamura Sunao, Naganuma Toru, Higuma Takumi, Kozuki Amane, Shite Junya, Suwa Satoru, Kume Teruyoshi, Uemura Shiro, Yamaguchi Masao, Fujii Hiroyuki, Kimura Shigeki, Naruse Genki, Okura Hiroyuki, Iwasaki Masamichi, Sugiyama Tomoyo, Yasuhara Sakiko, Dohi Tomotaka, Ashikaga Takashi, Nanasato Mamoru, Otake Hiromasa, Wakabayashi Kohei, Shinke Toshiro
Аннотация
METHODS AND RESULTS: The ATLAS-OCT trial was a prospective, multicentre, single-arm study enrolling STEMI patients within 24 h of symptom onset. OCT-guided PCI was preferred when feasible. This analysis included patients with analysable post-PCI OCT images. The primary endpoint was target vessel failure (TVF; all-cause death, target vessel myocardial infarction [TVMI], or target vessel revascularization [TVR]). OCT images were analysed independently, and outcomes assessed at 12 months. Of 632 patients, 439 (69.5%) underwent OCT-guided stenting with final analysable imaging. Mean minimal stent area (MSA) and stent expansion (SE) were 6.21 ± 2.27 mm² and 76.8 ± 15.6%, respectively. Optimization criteria (MSA > 4.5 mm² and/or SE > 70%) were met in 87.7%. Suboptimal expansion was associated with higher TVF (20.4% vs. 8.1%; HR 2.57, 95% CI: 1.29-5.11), driven by TVMI and TVR. Each 1 mm² MSA decrease and 10% SE reduction increased TVF odds by 23% and 33%, respectively. Minor OCT findings were not significantly associated with outcomes.
CONCLUSION: In STEMI, suboptimal MSA and SE determined by OCT were associated with higher adverse event risk. These findings support OCT-guided PCI optimization to improve outcomes and warrant further evaluation in randomized trials.
STUDY REGISTRATION: University Hospital Medical Information Network Clinical Trials Registry of Japan (UMIN-CTR number: 000048590).