PulseExploreJournal ClubResearchersJournals
Instagram
HomeJournal ClubExplore
Synapse
⌘+K
Synapse
April 29, 2026Journal of the American College of CardiologyOpen Access

Computed Tomography Angiography or Standard Care After Left Main PCI?

View Full Paper
Ask AI
Bookmark
Share

Why the study?

The clinical benefit of routine coronary computed tomography angiography after percutaneous coronary intervention for unprotected left main disease is uncertain.

Population

606 patients treated with second-generation drug-eluting stents for left main disease

Comparison

CCTA at 6 months vs standard care

Design

Prospective, multicenter, open-label randomized trial

Follow-up

18 months

Key result

Routine CCTA at 6 months after left main PCI did not significantly reduce the composite primary endpoint compared to standard care (11.9% vs 12.5%; HR 0.97; 95% CI 0.76-1.23; P=0.80).

Authors

FDFabrizio D’AscenzoECEnrico CerratoOFOvidio De Filippo

Discussion

Loading...

Member takes

Overview

No clear role for routine CCTA after left main PCI; leaves open net benefit of imaging-triggered revascularization.

Study Design

Type

RCT (n=606)

Blinding

Open-label

Randomization

1:1

Multicenter

Yes

PICO

P
Population
Unprotected left main disease after percutaneous coronary intervention (n=606)
I
Intervention / Comparator
Routine coronary computed tomography angiography (CCTA) vs Standard care (symptoms- or ischemia-driven care)
O
Primary Outcome
Composite of all-cause death, spontaneous myocardial infarction, unstable angina, or definite or probable stent thrombosis at 18 months — HR 0.97 (0.76-1.23), p=0.80

Main Result

Effect estimate: HR 0.97 (95% CI 0.76-1.23)

Absolute Event Rate: 11.9% vs 12.5%

p-value: p=0.80

Cite This Study

D’Ascenzo et al. (2025) conducted an RCT in Unprotected left main disease after percutaneous coronary intervention (n=606). Routine coronary computed tomography angiography (CCTA) vs. Standard care (symptoms- or ischemia-driven care) was evaluated on Composite of all-cause death, spontaneous myocardial infarction, unstable angina, or definite or probable stent thrombosis at 18 months (HR 0.97, 95% CI 0.76-1.23, p=0.80). Routine CCTA at 6 months after left main PCI did not significantly reduce the composite primary endpoint compared to standard care (11.9% vs 12.5%; HR 0.97; 95% CI 0.76-1.23; P=0.80).

synapsesocial.com/papers/69f178a3adb7394e289b48a1https://doi.org/10.1016/j.jacc.2025.07.060
View Full Paper
Ask AI
Bookmark
Share