title: Does optical coherence tomography optimize results of stenting? Rationale and study design.
abstract: BACKGROUND
  To date, no randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of coronary angioplasty for non-ST-segment elevation acute coronary syndromes.
  
  
  METHODS
  DOCTORS is a randomized, prospective, multicenter, open-label clinical trial to evaluate the utility of OCT to optimize results of angioplasty of a lesion responsible for non-ST-elevation acute coronary syndromes. Patients (n = 250) will be randomized to undergo OCT-guided angioplasty (use of OCT to optimize procedural result, including change to strategy with the possibility of additional interventions) or angioplasty under fluoroscopy alone. The primary end point is the functional result of the angioplasty procedure as assessed by fractional flow reserve (FFR) measured at the end of the procedure. Secondary end points include safety of OCT in the context of angioplasty for ACS, percentage of patients in whom OCT reveals suboptimal result of stenting, percentage of patients in whom a change in procedural strategy is decided based on OCT data, correlation between quantitative measures by OCT and FFR, determination of a threshold for quantitative OCT measure that best predicts FFR ≥ 0.90, and identification of OCT variables that predict postprocedure FFR. Adverse cardiac events (death, recurrent myocardial infarction, stent thrombosis, and repeat target lesion revascularization) at 6 months will be recorded.
  
  
  CONCLUSIONS
  The DOCTORS randomized trial (ClinicalTrials.gov NCT01743274) is designed to investigate whether use of OCT yields useful additional information beyond that obtained by angiography alone and, if so, whether this information changes physician strategy and impacts on the functional result of angioplasty as assessed by FFR.
authors: Department of Cardiology, EA3920, University Hospital Jean Minjoz, 25000 Besançon, France. Electronic address: nicolas.meneveau@univ-fcomte.fr.
authors: Nicolas
authors: N
authors: Meneveau
authors: Department of Cardiology, EA3920, University Hospital Jean Minjoz, 25000 Besançon, France.
authors: Fiona
authors: F
authors: Ecarnot
authors: University Hospital Gabriel Montpied, Clermont-Ferrand, France.
authors: Geraud
authors: G
authors: Souteyrand
authors: University Hospital Gabriel Montpied, Clermont-Ferrand, France.
authors: Pascal
authors: P
authors: Motreff
authors: Centre Chirurgical Marie Lannelongue, Paris, France.
authors: Christophe
authors: C
authors: Caussin
authors: University Hospital, Lille, France.
authors: Eric
authors: E
authors: Van Belle
authors: Nouvel Hôpital Civil, Strasbourg, France.
authors: Patrick
authors: P
authors: Ohlmann
authors: Nouvel Hôpital Civil, Strasbourg, France.
authors: Olivier
authors: O
authors: Morel
authors: Centre Hospitalier, Belfort, France.
authors: Alain
authors: A
authors: Grentzinger
authors: Brabois University Hospital, Vandœuvre les Nancy, France.
authors: Michael
authors: M
authors: Angioi
authors: Department of Cardiology, EA3920, University Hospital Jean Minjoz, 25000 Besançon, France.
authors: Romain
authors: R
authors: Chopard
authors: Department of Cardiology, EA3920, University Hospital Jean Minjoz, 25000 Besançon, France.
authors: François
authors: F
authors: Schiele
mesh_terms: D054058:Acute Coronary Syndrome / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D053805:Fractional Flow Reserve, Myocardial; D006801:Humans; D012107:Research Design; D015607:Stents; D041623:Tomography, Optical Coherence