title: Impact of an optical coherence tomography guided approach in acute coronary syndromes: A propensity matched analysis from the international FORMIDABLE-CARDIOGROUP IV and USZ registry.
abstract: OBJECTIVE
  To determine the potential clinical impact of OCT (Optical Coherence Tomography) during primary percutaneous coronary intervention in patients presenting with ACS (Acute Coronary Syndrome).
  
  
  RESULTS
  FORMIDABLE is a multicentre retrospective registry enrolling all patients presenting with ACS and treated with an OCT-guided approach, while the USZ registry enrolled patients treated with a standard angiography guided approach. Multivariate adjustment was performed via a propensity score matching. The number stents useds was the primary outcome, while the incidence of MACE (a composite of death, myocardial infarction, target vessel revascularization, and stent thrombosis) was the secondary endpoint. A total of 285 patients OCT-guided and 1,547 angiography guided patients were enrolled, resulting in 270 for each cohort after propensity score with matching. Two stents were used in 12% versus 34%; 3 stents in 8% versus 38% of the patients (P < 0.001). After a follow up of 700 days (450-890), there was no difference in myocardial infarction (6% vs. 6%, P = 0.86), while MACE (11% vs. 16%, P = 0.06), target vessel revascularization (2% vs. 4%, P = 0.15) and stent thrombosis rates (0% vs. 2.7%, P = 0.26) were numerically lower for the OCT-guided cohort but none of these endpoints did reach statistical significance.
  
  
  CONCLUSIONS
  An OCT-guided approach reduced the number of stents used, number of patients treated with more than one stent, while there was no statistically significant difference in clinical endpoints while most of them were numerically lower, including stent thrombosis rates. © 2016 Wiley Periodicals, Inc.
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Mario
authors.identifier: http://orcid.org/0000-0003-0571-3918
authors.initials: M
authors.lastname: Iannaccone
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: D'Ascenzo
authors.affiliation: Department of Cardiology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Antonio H
authors.initials: AH
authors.lastname: Frangieh
authors.affiliation: Division of Cardiology, Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.affiliation: Department of Cardiology, "S.G. Bosco Hospital,", Turin, Italy.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: Ugo
authors.affiliation: Department of Cardiology, "S.G. Bosco Hospital,", Turin, Italy.
authors.forename: Giacomo
authors.initials: G
authors.lastname: Boccuzzi
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Bertaina
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Mancone
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Montefusco
authors.affiliation: Cardiology Department, Institut Mutualiste Montsouris, Paris, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Amabile
authors.affiliation: Department of Cardiovascular, Respiratory, Nephrologic, Anesthesiologic and Geriatric Sciences, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Gennaro
authors.initials: G
authors.lastname: Sardella
authors.affiliation: Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Motreff
authors.affiliation: First Department of Cardiology, Hippokration Hospital, Athens Medical School, Athens, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Toutouzas
authors.affiliation: Department of Cardiology, "S.G. Bosco Hospital,", Turin, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Colombo
authors.affiliation: Department of Cardiology, "S.G. Bosco Hospital,", Turin, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Garbo
authors.affiliation: Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy and University Heart Center, Department of Cardiology, University Hospital Zurich, Switzerland.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Biondi-Zoccai
authors.affiliation: Division of Cardiology, Cardio-thoracic-vascular Department, Ferrarotto Hospital, University of Catania, Catania, Italy.
authors.forename: Corrado
authors.initials: C
authors.lastname: Tamburino
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Omedè
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Moretti
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: D'amico
authors.affiliation: Cardiology Department, CHU Clermont-Ferrand, Clermont-Ferrand 63000, France Cardio Vascular Interventional Therapy and Imaging (CaVITI), UMR CNRS 6284, Auvergne University, Clermont-Ferrand, France.
authors.forename: Geraud
authors.initials: G
authors.lastname: Souteyrand
authors.affiliation: Division of Cardiology, University of Geneva, Geneva, Switzerland.
authors.forename: Pascal
authors.initials: P
authors.lastname: Meieir
authors.affiliation: Department of Cardiology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Lüscher
authors.affiliation: "Città della Scienza e della Salute," Department of Cardiology, University of Turin, Turin, Italy.
authors.forename: Fiorenzo
authors.initials: F
authors.lastname: Gaita
authors.affiliation: Department of Cardiology, Zurich University Hospital, Zurich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Templin
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D000368:Aged; D000789:Angina, Unstable / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D017023:Coronary Angiography; D003328:Coronary Thrombosis / Q000209:etiology; D005060:Europe; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D000072658:Non-ST Elevated Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods* / Q000401:mortality; D011237:Predictive Value of Tests; D057216:Propensity Score; D012008:Recurrence; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D015607:Stents; D013997:Time Factors; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome
keywords: acute coronary syndrome; drug eluting stent; optical coherence tomography