Vol. 23 No. 3 (2019)
CORONARY ARTERY DISEASES

Use of optical coherence tomography for intermediate coronary artery lesions

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  • P. Ermolaev,
  • T. Khramykh,
  • A. Vyaltsin
P. Ermolaev
Omsk State Medical University, Omsk, Omsk State Regional Hospital, Omsk
Bio
T. Khramykh
Omsk State Medical University, Omsk
A. Vyaltsin
Omsk State Medical University, Omsk
DOI: https://doi.org/10.21688/1681-3472-2019-3-47-56

Published 2019-11-27

Keywords

  • coronary angiography,
  • coronary arteries,
  • coronary heart disease,
  • endovascular intervention,
  • optical coherence tomography

How to Cite

Ermolaev, P., Khramykh, T., & Vyaltsin, A. (2019). Use of optical coherence tomography for intermediate coronary artery lesions. Patologiya Krovoobrashcheniya I Kardiokhirurgiya, 23(3), 47–56. https://doi.org/10.21688/1681-3472-2019-3-47-56

Copyright (c) 2019 Ermolaev P. A., Khramykh T. P., Vyaltsin A. S.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Abstract

Aim. To compare the results of interventions for intermediate coronary lesions, which were operated via angiography and optical coherence tomography (OCT).
Methods. We performed a study including 130 stable patients with intermediate coronary lesions (40%–70%). The first group (n = 65) underwent angiography control; the second group (n = 65) underwent OCT control. Morphometric coronary indicators were analyzed intraoperatively. During the 12-month follow-up period, major adverse cardiovascular events incidence, angina recurrence frequency, restenosis, and stent thrombosis were assessed.
Results. More pronounced coronary changes were noted in the OC group, as evidenced by stenosis indicators (51.5% [45.2–68.4] vs. 78.6 [65.7–80.3], p = 0.012), lesion length (18.4 mm [15.6–20.3] vs. 26.8 [24.6–32.2], p = 0.038), and plaque instability frequency (4.6% [3/65] vs. 12.3% [8/65], p = 0.048). In the OCT group, decision to perform stenting was more common (33.8% [22/65] vs. 83.1%) [54/65], p < 0.001). In stented patients, differences were noted in major adverse cardiovascular events frequency (13.6% vs. 0%, p = 0.021), angina return (36.3% vs. 3.7%, p < 0.001, odds ratio (OR) 14,857 [2,830–77,990]), and stent restenosis (31.8% vs. 1.8%), p < 0.001, OR 24,733 [2,817–217,125]), with an advantage in favor of OCT. In patients receiving drug therapy, differences were noted in angina recurrence frequency (60.5% vs. 18.1%, p = 0.005, OR 6,882 [1,322–35,824]), with an advantage in favor of OCT.
Conclusion. The use of OCT for intermediate coronary lesions revealed prominent lesions and optimized intervention outcomes, accompanied by reduced major adverse cardiovascular events frequency, myocardial infarction, angina recurrence, and stent restenosis at 12 months.

Received 5 July 2019. Revised 29 October 2019. Accepted 5 November 2019.

Funding: The study did not have sponsorship.

Conflict of interest: Authors declare no conflict of interest.

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