<div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1218220566" paraeid="{ab2c1f0e-5650-4871-87ea-56f298f46f8f}{212}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">Intravascular-ultrasound imaging (IVUS)-guided percutaneous coronary intervention (PCI)<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">yields similar outcomes compared with</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>angiography-guided PCI in patients with left main<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">(LM)<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">coronary artery disease</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>(CAD)</span><span class="NormalTextRun SCXW35699682 BCX0">, results from the OPTIMAL trial sho</span><span class="NormalTextRun SCXW35699682 BCX0">w.</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1390126111" paraeid="{30662fa1-bbcc-43a2-9f81-5a467e45982d}{59}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">“</span><span class="NormalTextRun SCXW35699682 BCX0">The results of the OPTIMAL trial may challenge the requirement to always use intracoronary imaging guidance when performing PCI in stenoses of the left main coronary artery, which suggests that angiography alone may be appropriate when procedures are performed by expert IVUS operators at high-volume centers,” Luca Testa, MD, of the P</span><span class="NormalTextRun SCXW35699682 BCX0">oliclinico San Donato in Milan, Italy, said in a statement to the American College of Cardiology (ACC) media.</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1891093505" paraeid="{eef512f3-8cc8-4fbf-81eb-669d01609a55}{113}"><span class="NormalTextRun SCXW35699682 BCX0">Dr. Testa presented these findings on Monday during a late-breaking clinical trials session at the ACC 2026 Scientific Sessions in New Orleans, and data were simultaneously published in a manuscript online in the<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">New England Journal of Medicine</span><span class="NormalTextRun SCXW35699682 BCX0">.</span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="611833954" paraeid="{e1bb95e7-87a4-4eb2-9e30-60130dca7c3d}{171}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">Patients with<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">LM CAD often undergo PCI as an alternative t</span><span class="NormalTextRun SCXW35699682 BCX0">o coronary artery bypass grafting (CABG)</span><span class="NormalTextRun SCXW35699682 BCX0">. Prior data are unclear whether IVUS or traditional angiographic guidance during PCI is best for this patient population.</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1179659152" paraeid="{1bcee7db-49e9-4a1f-92fa-7a0b9597dd2c}{214}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">The international, multicenter, open-label</span><span class="NormalTextRun SCXW35699682 BCX0">, superiority</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>OPTIMAL (Optimization of Left Main PCI With Intravascular Ultrasound) trial</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>took place across Italy,<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">Spain</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>and the U.K.</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="2064969459" paraeid="{65e6af95-d0c8-4052-9f4a-bf58c48fe5f6}{165}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">A patient-oriented composite of all-cause death, stroke, myocardial<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">infarction</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>or revascularization at the longest follow-up was the primary endpoint in this trial.</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1939822456" paraeid="{28fb00dd-6223-4db7-8d41-b36b410f9df8}{105}"><span class="NormalTextRun SCXW35699682 BCX0">A total of 806 patients were included (mean age=71.4 years, 78.4% men; 34.7% had diabetes): IVUS-guided PCI consisted of 401 patients and angiography-guided PCI consisted of 405 patients.<span> </span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1532419419" paraeid="{8b008d11-18b8-4260-8f75-41d6d4fa5101}{91}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">The median follow-up time was 2.9 years,</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>and 33.7% of patients in the IVUS group and 30.9% of patients in the angiography group experienced the primary endpoint (hazard ratio [HR]=1.11; 95% confidence interval [CI]=0.87-1.42; p=0.40).</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="603358135" paraeid="{3a2dd13b-d761-4e5b-b873-f1a3876042ff}{165}"><span class="NormalTextRun SCXW35699682 BCX0">Individual components of the primary endpoint were also analyzed and had similar rates across both groups. Safety and procedure-related events were also not significantly different between IVUS and angiography patients.</span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="104592230" paraeid="{6ed2a7d1-29e6-4c91-b84e-5bd87dae0767}{66}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">“Adherence to<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">established</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>procedural standards, especially when the distal left main bifurcation was involved, and the use of contemporary stent platforms and pharmacology may have reduced potential differences in the outcomes between the two groups,” Dr. Testa said during his presentation.</span></span><span class="EOP SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="562608158" paraeid="{fc3bcb9f-a162-4976-ac6d-26dcb73857c9}{46}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">Overall, the OPTIMAL trial results<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">indicate</span><span class="NormalTextRun SCXW35699682 BCX0"><span> </span>that IVUS-guided PCI and angiography-guided PCI yield similar outcomes in patients with LM CAD.<span> </span></span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="441828636" paraeid="{f8c80982-5f3a-4307-bda1-230d3e488037}{188}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><span class="NormalTextRun SCXW35699682 BCX0">These findings may be influential in the creation of clinical guidelines for PCI, as<span> </span></span><span class="NormalTextRun SCXW35699682 BCX0">guidelines recently recommended the use of IVUS imaging-guided PCI in these patients, Dr. Testa noted.</span></span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="887456418" paraeid="{ddc03562-4a28-45ac-8759-b9be11ad05bb}{216}"><span class="NormalTextRun SCXW35699682 BCX0">This trial was sponsored by the European Cardiovascular Research Institute in Rotterdam, the Netherlands.</span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1791693245" paraeid="{4cf58181-5b3f-4c29-a30b-d53ee9be04ca}{31}"><strong><span class="NormalTextRun SCXW35699682 BCX0">Source:</span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1423229191" paraeid="{021c6ca6-070f-4f9e-9a47-ddd4958144bd}{63}"><span class="NormalTextRun SCXW35699682 BCX0">Testa L, Torre Hernandez JM, De Maria GL, et al. IVUS-guided versus angiography-guided PCI in unprotected left main coronary disease.<span> </span></span><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW35699682 BCX0"><em><span class="NormalTextRun SCXW35699682 BCX0">N</span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW35699682 BCX0"> Engl</span></em><span class="NormalTextRun SCXW35699682 BCX0"><em> J Med</em>.<span> </span></span></span><span class="NormalTextRun SCXW35699682 BCX0">2026 March 30 (Article in Press).</span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW35699682 BCX0"> <p class="Paragraph SCXW35699682 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1170116056" paraeid="{4cf58181-5b3f-4c29-a30b-d53ee9be04ca}{81}"><strong><span class="NormalTextRun SCXW35699682 BCX0">Image Credit: Screenshot by Bailey G. Salimes, CRTonline.org.</span><span class="EOP Selected SCXW35699682 BCX0" data-ccp-props="{}"> </span></strong></p> </div>