Use of intracoronary imaging to guide percutaneous intervention is associated with improved one-year mortality in Australian patients.

Abstract

Background: The use of intravascular coronary imaging (IC)), comprising of intravascular ultrasound (IVUS) and optical computed topography (OCT), during percutaneous coronary intervention (PCI) is increasing. Use of ICI during PCI has been associated with improved clinical outcomes compared with traditional angiography guided PCI. Overseas data have shown improved mortality but currently there has been no real-world assessment of Australian outcomes. Our study aims to look at the current use and mortality outcomes of ICI in Victoria. Methods/Results: A prospective observation study was performed using data from the Victorian Cardiac Outcome Registry (VCOR). 80,635 patients from 32 centres who underwent PCI over the study period (2014–2020) were included. Of this number a total of 1,785 patients had coronary imaging during PCI. The majority of these cases were performed in metropolitan Victoria (n=1,304). At one-year, patients who had intravascular coronary imaging guided PCI had reduced mortality compared to patients who had traditional angiography guided PCI (HR: 0.8, CI: 0.68–0.94, p=0.008). Conclusion: This is the first large scale Australian data showing that use of ICI to guide PCI improves mortality to compared to traditional angiography guided PCI. This data mirrors American registry findings. These results supported increasing use and access to ICI for patients requiring PCI.