This observational study, the first ever formally to appraise OCT guidance for PCI decision-making, suggests that the use of OCT can improve clinical outcomes of patients undergoing PCI.

Preprocedural CRP level, an easily measurable marker of acute phase response, is a powerful predictor of both early and late outcome in patients undergoing single vessel PTCA, suggesting that early complications and clinical restenosis are markedly influenced by the preprocedural degree of inflammatory cell activation.

Background-Systemic levels of myeloperoxidase predict prognosis in patients with acute coronary syndromes and are considered a marker of plaque vulnerability. It is not known whether myeloperoxidase is associated with different coronary morphologies (ie, rupture or erosion of the culprit lesion) in patients with acute coronary syndrome. Methods and Results-Twenty-five consecutive patients (aged 67Ϯ11 years; 15 men [60%]; 13 [52%] with non-STsegment elevation acute coronary syndrome and 12 [48%] with acute ST-segment elevation myocardial infarction) were enrolled. Optical coherence tomography classified the culprit lesion as ruptured in 18 (72%) or eroded in 7 patients (28%) and detected intraluminal thrombus in 89% of ruptured plaques and 100% of eroded plaques. Baseline systemic levels of serum myeloperoxidase were significantly higher in patients with an eroded plaque than in those with a ruptured plaque (median, 2500 ng/mL; 25th to 75th percentile, 1415 to 2920 versus median, 707 ng/mL; 25th to 75th percentile, 312 to 943; Pϭ0.001), whereas C-reactive protein levels did not differ significantly (median, 11.3 mg/L; 25th to 75th percentile, 1.3 to 28.5 versus median, 3.9 mg/L; 25th to 75th percentile, 1.3 to 17.8; Pϭ0.76, respectively). In addition, the density of myeloperoxidase-positive cells within thrombi overlying plaques in postmortem coronary specimens retrieved from sudden coronary death victims was significantly higher in lesions with erosion (nϭ11) than ruptures (nϭ11) (median, 1584; 25th to 75th percentile, 1088 to 2135 cells/mm 2 versus median, 579; 25th to 75th percentile, 442 to 760 cells/mm

The present registry shows that FD-OCT is a feasible and safe technique for guidance of coronary interventions. Randomised studies will confirm whether the use of FD-OCT will improve the clinical outcome.

Aims: To facilitate OCT images acquisition we developed a novel, simplified, non-occlusive technique based on manual infusion of a viscous isosmolar solution. The aims of the present study was to address the safety and efficacy of non-occlusive OCT images acquisition modality in a patient population with complex coronary lesions, and in various clinical scenarios. Methods and results: OCT assessment was performed with the LightLab OCT Imagewire™ in 64 patients. The imaging acquisition technique was aimed at target lesion and proximal and distal reference segments. OCT images were deemed of good quality if they allowed both an accurate measurement of luminal area and a qualitative classification of the superficial plaque components. In 60 patients (93.7%), the procedure was successful. The mean images acquisition time was 5.3±1.4 minutes. No major complications such as death, myocardial infarction or major arrhythmias were recorded. The average length of imaged segments was 28.6±6.1 mm and 95.1% of the imaged segments were deemed of sufficient quality to evaluate luminal area and plaque morphology (intra-observer and inter-observer variability 0.71, p<0.0001 and 0.68, p<0.0001 respectively). Conclusions. The non-occlusive modality of OCT image acquisition is safe and effective, and promises to simplify the complex current occlusive technique, leading to a marked reduction of procedural time.