Artificial Intelligence–Based Fully Automated Quantitative Coronary Angiography vs Optical Coherence Tomography–Guided PCI
Yongcheol Kim, Yongcheol Kim, Hyuck‐Jun Yoon, Jon Suh, Si‐Hyuck Kang, Young‐Hyo Lim, Duck Hyun Jang, Jae Hyoung Park, Eun‐Seok Shin, Jang‐Whan Bae, Jang Hoon Lee, Jun‐Hyok Oh, Do‐Yoon Kang, Jihoon Kweon, Min‐Woo Jo, Sung‐Cheol Yun, Duk‐Woo Park, Young‐Hak Kim, Young‐Hak Kim, Seung‐Jung Park, Hanbit Park, Jung-Min Ahn, Y. Kim, Y. Kim, H.J. Yoon, J. Suh
Abstract
BACKGROUND: Recently developed artificial intelligence-based coronary angiography (AI-QCA, fully automated) provides real-time, objective, and reproducible quantitative analysis of coronary angiography without requiring additional time or labor. OBJECTIVES: This study aimed to evaluate the efficacy of AI-QCA-assisted percutaneous coronary intervention (PCI) compared to optical coherence tomography (OCT)-guided PCI in terms of post-PCI results. METHODS: . RESULTS: in the OCT group (difference, -0.16; 95% CI: -0.59 to 0.28; P for noninferiority < 0.001). Other OCT-defined endpoints, such as stent underexpansion (50.8% [101/199] vs 54.6% [107/196]; P = 0.48), dissection (15.6% [31/199] vs 12.8% [25/196]; P = 0.42), and untreated reference segment disease (15.1% [30/199] vs 13.3% [26/196]; P = 0.61), were not significantly different between groups, except for a higher incidence of stent malapposition in the AI-QCA group (13.6% [27/199] vs 5.6 [11/196]; P = 0.007). CONCLUSIONS: This study demonstrated the noninferiority of AI-QCA-assisted PCI to OCT-guided PCI in achieving MSA with comparable OCT-defined endpoints. (Fully Automated Quantitative Coronary Angiography Versus Optical Coherence Tomography Guidance for Coronary Stent Implantation [FLASH]; NCT05388357).