Comparing Optical Coherence Tomography and Angiography Guided PCI in Adults with Acute Myocardial Infarction

What this Trial Is About

Researchers are comparing the effects of optical coherence tomography OCT-guided versus angiography-guided percutaneous coronary intervention PCI in patients who have suffered an acute myocardial infarction AMI. The study aims to determine if using OCT imaging during PCI can improve clinical outcomes by better guiding stent placement and optimization compared to traditional angiography alone. This trial addresses limitations of angiography and builds on previous research that has not conclusively shown long-term benefits of OCT guidance in AMI treatment. Participants will be randomly assigned to one of two groups one receiving standard PCI guided by angiography and the other receiving PCI guided by OCT imaging. In the OCT group, OCT imaging is used before, during, and after stent placement to optimize treatment, with specific criteria for stent expansion, apposition, and edge dissection. The angiography group will have PCI performed using standard visual assessments and stent optimization based on angiographic findings. Both groups undergo PCI procedures aimed at reopening blocked coronary arteries causing the heart attack. During the study, participants will be monitored for up to two years following their PCI procedure to assess clinical outcomes such as target vessel failure and other cardiac events. Researchers will collect data on death rates, myocardial infarctions, revascularization needs, stent thrombosis, and procedural details like fluoroscopy time and contrast use. Safety measures including monitoring for kidney injury related to contrast dye will also be included. This long-term follow-up will help determine the impact of OCT-guided PCI compared to angiography-guided PCI in patients with AMI.

OCT Versus Angiography for Culprit Lesion Revascularization in Acute Myocardial Infarction PatiEnts