Optical Coherence Tomography-Guided Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: Rationale and Design of the ATLAS-OCT Study.

Even after successful revascularization with primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI), subsequent adverse events still occur. Previous studies have suggested potential benefits of intravascular imaging, including optical coherence tomography (OCT). However, the feasibility of OCT-guided primary PCI has not been systematically examined in these patients. The ATLAS-OCT (ST-elevation Acute myocardial infarcTion and cLinicAl outcomeS treated by Optical Coherence Tomography-guided percutaneous coronary intervention) trial was designed to investigate the feasibility of OCT guidance during primary PCI for STEMI in experienced centers with expertise on OCT-guided PCI as a prospective, multicenter registry of consecutive patients with STEMI who underwent a primary PCI. The sites' inclusion criteria are as follows: (1) acute care hospitals providing 24/7 emergency care for STEMI, and (2) institutions where OCT-guided PCI is the first choice for primary PCI in STEMI. All patients with STEMI who underwent primary PCI at participating sites will be consecutively enrolled, irrespective of OCT use during PCI. The primary end point will be the rate of successful OCT imaging during the primary PCI. As an ancillary imaging modality to angiography, OCT provides morphologic information during PCI for the assessment of plaque phenotypes, vessel sizing, and PCI optimization. Major adverse cardiac events, defined as a composite of all-cause death, myocardial infarction, and target vessel revascularization at 1 year, will also be recorded. The ATLAS-OCT study will clarify the feasibility of OCT-guided primary PCI for patients with STEMI and further identify a suitable patient group for OCT-guided primary PCI.

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Déclaration de conflit d'intérêts

Declaration of Competing Interest Dr. Ako received a speaking honorarium from Abbott Medical Japan, LLC. Dr. Minami received speaking honorarium and consultant fees from Abbott Medical Japan, LLC. Dr. Shite has received honoraria from Abbott Medical Japan, Nipro, and Terumo. Dr. Kozuki has received honoraria from Abbott Medical (Japan). Dr. Shishido received remuneration for lectures from Abbott Medical, Japan. Dr. Uemura received remuneration from Abbott Vascular Japan, Daiichi-Sankyo, Novartis Pharma, Bayer, and Amgen and scholarship funds from Abbott Vascular Japan. Dr. Kume received remuneration from Abbott Vascular (Japan). Dr. Nanasato received remuneration for lectures from Boston Scientific (Japan). Dr. Otake received a speaking honorarium and research grant from Abbott Vascular, Japan. Dr. Shinke received personal fees and research grants from Abbott Medical Japan, LLC. The remaining authors have no competing interests to declare.