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
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No clear role for routine CCTA after left main PCI; leaves open net benefit of imaging-triggered revascularization.
RCT (n=606)
Open-label
1:1
Yes
Effect estimate: HR 0.97 (95% CI 0.76-1.23)
Absolute Event Rate: 11.9% vs 12.5%
p-value: p=0.80
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).