Preventive PCI or Medical Therapy Alone for Vulnerable Atherosclerotic Coronary Plaque

Sub-analysis for each imaging test will be performed as below;

• NIRS(Near-infrared spectroscopy)
• OCT(Optical coherence tomography)
• VH-IVUS(IVUS-derived virtual histology)
• IVUS(Intravascular ultrasonography)

Extended follow-up:

Considering the nature of functionally insignificant coronary stenosis with vulnerable plaque, most subjects are watched for extended follow-up after the planned 2-year follow-up time point.

Inclusion criteria

• Patients aged ≥18 years
• Patients with suspected or known Coronary artery disease who are undergoing invasive cardiac catheterization
• Patients with at least one significant stenosis (diameter stenosis >50%) with Fractional Flow Reserve (FFR) >0.80 and meeting two of the following criteria:

• MLA(minimal luminal area)<4mm2
• Plaque burden>70%
• Large lipid-rich plaque on NIRS(Intracoronary Near-Infrared Spectroscopy), defined as MaxLCBI4mm>315
• TCFA(thin-cap fibroatheroma) defined as fibrous cap thickness <65 μm and arc >90° on optical coherence tomography (OCT) or ≥10% confluent necrotic core with >30° abutting the lumen in three consecutive slices on Virtual-histology intravascular ultrasound (VH-IVUS)
• Eligible for percutaneous coronary intervention with Absorb Bioresorbable Vascular Scaffold or Everolimus Eluting Stent
• Reference vessel diameter 2.75-4.0
• Lesion length ≤ 40mm
• Willing and able to provide informed written consent

Exclusion criteria

• Patients for whom the preferred treatment is CABG(Coronary artery bypass grafting)
• Patients with stented lesions
• Patients with bypass graft lesions
• Patients with three or more target lesions
• Patients with two target lesions in the same coronary territory
• Patients with heavily calcified or angulated lesions
• Patients with bifurcation lesions requiring 2 stenting technique
• Patients with contraindications to or planned discontinuation of dual antiplatelet therapy within 1 year
• Patients with life expectancy <2 years
• Patients with planned cardiac or major noncardiac surgery
• Woman who are breastfeeding, pregnant or planning to become pregnant during the course of the study