OPTical Coherence Tomography IMAging in Patients With Acute myocardiaL Infarction (OPTIMAL)

Study Overview
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Brief Summary
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The purpose of the study is to investigate the clinical outcomes, safety and cost-effectiveness of intravascular OCT imaging in patients with acute myocardial infarction undergoing percutaneous coronary intervention (PCI). About 4500 patients with acute myocardial infarction (estimated 1500 with OCT guidance and 3000 without OCT guidance during PCI）will be prospectively enrolled in 20 sites in China. The total duration of the study is expected to be 5 years, 2 years for enrolment and 3 years for follow up.

Detailed Description
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This is a prospective, multi-center, non-randomized, observational registry study of patients with acute myocardial infarction (AMI) that require catheterization. The purpose of this registry is to investigate the clinical outcomes, safety and cost-effectiveness of intravascular OCT imaging in patients with AMI undergoing PCI.The duration of the study is expected to be 5 years, 2 years for enrolment and 3 years for total follow up.The clinical study will be conducted in 20 centers in China.Approximately 4500 subjects (1500 with OCT imaging and 3000 without OCT imaging) will be enrolled in this study.Subjects will be followed up at 1, 3, 6, 12months and every 6 months afterwards up to 5 years. All subjects need to be followed for at least 12 months.

Official Title
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OPTical Coherence Tomography IMAging in Patients With Acute myocardiaL Infarction During Primary PCI (OPTIMAL)

Conditions
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Acute Myocardial Infarction

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients presenting with:a.Symptoms of myocardial ischemia lasting for ≥ 30 minutes.b.Definite ECG changes indicating STEMI: ST elevation of greater than 0.1 mV in two contiguous limb leads or 0.2 mV in two contiguous precordial leads, or presumed new left bundle branch block. c. NSTEMI Referred for primary PCI. Are able to provide written Informed Consent prior to any study related procedure. Exclusion Criteria: Patient who is unable to comply with the follow-up schedule. Left main occlusion Unable to restore TIMI flow grade III before stenting Prior coronary artery bypass surgery (CABG) Cardiogenic shock Patient who has any medical conditions that in the opinion of the investigator will not be appropriate to participate in the study. Patient has a life expectancy of less than 6 month due to any condition. Age ≤ 18 years

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| OCT group<br>1500 AMI patients with OCT imaging guidance during PCI | |
| CAG group<br>3000 AMI patients without OCT imaging guidance during PPCI | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Major cardiovascular adverse events rate | In patients treated conservatively, the safety objectives are to evaluate the occurrence of any adverse events in 1 year (re-infarction, re-hospitalization, revascularization by PCI or CABG, cardiac death, stoke, and major bleeding) | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The rate of procedural strategy changes during the primary PCI | The rate of procedural strategy changes (thrombus aspiration or not, stenting or not, postdilation or not.) during the primary PCI. | baseline | 
| The incidence of procedural complications | The incidence of procedural complications including coronary artery dissection, acute occlusion, thrombosis, re-infarction, emergent coronary artery bypass graft, bleeding, no/slow reflow, and death. | baseline | 
| the indience of different plaque characteristic in the setting of STEMI | The incidence of plaque erosion, plaque rupture, calcified nodules, and other uncommon causes in the setting of STEMI. | baseline | 
| Major cardiovascular adverse events rate | The incidence of major adverse cardiovascular events (MACE) at 24 months and 36 months after index procedure. | 2 and 3 year | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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STEMI, NSTEMI