Impact of Diabetes on Outcomes of Contemporary PCI Guided by OCT vs Angiography: The ILUMIEN IV Trial.
Luise Gaede, Stephan Achenbach, Mohamed Marwan et al.
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In 30 seconds
The ILUMIEN IV trial evaluated the impact of diabetes on outcomes following percutaneous coronary intervention (PCI) guided by optical coherence tomography (OCT) versus angiography in 2,487 patients. The study found that diabetic patients had higher 2-year rates of target vessel failure (9.9% vs 6.3%) and serious major adverse cardiovascular events (5.3% vs 2.7%) compared to nondiabetic patients, despite OCT guidance.
Key findings
- Diabetic patients had a 2-year target vessel failure rate of 9.9% compared to 6.3% in nondiabetic patients.
- The adjusted hazard ratio for target vessel failure in diabetics was 1.48 (95% CI: 1.09-2.02; P = 0.01).
- Serious major adverse cardiovascular events occurred in 5.3% of diabetics versus 2.7% of nondiabetics.
- OCT guidance did not reduce target vessel failure or serious MACE in either diabetic or nondiabetic patients.
Why it matters
Understanding the increased risk of adverse events in diabetic patients undergoing PCI is crucial for risk stratification and management. This study highlights the persistent challenges faced by this population, even with advanced procedural guidance.