OCT for Optimizing Long-Term Clinical Results in Left Main PCI-Dream or Reality? Results from a Single-Center High-Volume Registry.

In the MAIN-COMPARE study, there was a significant trend towards lower mortality rates for IVUS-guided LM PCI when compared with angiography guidance (6.0% versus 13.6%, log-rank p = 0.063; hazard ratio, 0.54; 95% CI, 0.28 to 1.03; Cox model p = 0.061) [ 10 ].

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Among the covariates, OCT—approaching significance ( p = 0.063)—had a 63% reduction in hazard (HR = 0.370, p = 0.063), indicating a strong protective effect but without reaching significance; age—significant ( p = 0.035)—with Exp (B) = 1.030, suggesting each year in age increases hazard by 3%; female sex—significant with p = 0.042—suggests a protective effect compared to male counterparts; and ‘true’ bifurcation type—significant with p = 0.027—was associated with a significant increase in mortality when compared to simple bifurcations or ostial lesions (HR = 1.787) 4.4.

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In the multivariable Cox proportional hazards model, adjusting for other relevant covariates, OCT was borderline non-significantly independently associated with a 63% reduction in mortality (HR = 0.37, p = 0.063).

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Several independent predictors were identified to have statistical significance (age, sex, and true bifurcations), while others approached significance (LVEF- p = 0.067 and SYNTAX score- p = 0.061).

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While sex, age, and bifurcation type were significant predictors and syntax score was a borderline significant predictor for long-term mortality, procedural aspects, such as POT or KBI, did not influence the outcomes.

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The type of clinical presentation, however, did not reach statistical significance in any of the multivariable analysis models.

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