# PREVENT: langetermijn follow-up van preventieve PCI bij kwetsbare plaques

*geplaatst 2025-08-21 · Preventie · European heart journal · doi 10.1093/eurheartj/ehaf273 · https://hartvaat.nl/2025/08/21/prevent-langetermijn-follow-up-van-preventieve-pci-bij-kwetsbare-plaques/*

Langetermijndata van PREVENT bevestigden het voordeel van preventieve PCI bij kwetsbare plaques geïdentificeerd met IVUS/OCT. Het paradigma van plaquegerichte interventie wint aan bewijs.

## English: Preventive percutaneous coronary intervention for non-flow-limiting vulnerable atherosclerotic coronary plaques in diabetes: the PREVENT trial.

Long-term PREVENT data confirmed the benefit of preventive PCI for vulnerable plaques identified by IVUS/OCT in diabetic patients. The paradigm of treating non-flow-limiting high-risk lesions continues to gain evidence.

## Abstract (original, from the publication)

BACKGROUND AND AIMS: The efficacy and safety of preventive percutaneous coronary intervention (PCI) for treating vulnerable plaques in diabetic patients remain unclear. METHODS: The PREVENT (Preventive Coronary Intervention on Stenosis with Functionally Insignificant Vulnerable Plaque) trial was a randomized clinical trial that compared preventive PCI plus optimal medical therapy with optimal medical therapy alone in patients with non-flow-limiting (fractional flow reserve >0.80) vulnerable plaques identified via intracoronary imaging. Randomization was stratified by diabetes status. The primary endpoint was a composite of cardiac death, target-vessel myocardial infarction, ischaemia-driven target-vessel revascularisation, or hospitalization for unstable or progressive angina at 2 years. RESULTS: Among 1606 randomized patients, 490 (30.5%) had diabetes. Diabetic patients underwent PCI for non-target lesions before randomization more frequently than non-diabetics (40.6% vs. 33.8%, P = .009). There were no significant differences in the incidence of the primary endpoint between diabetic and non-diabetic patients [1.8% vs. 1.9%; hazard ratio 0.98; 95% confidence interval 0.45-2.14); P = .956]. However, the primary endpoint at 2 years was less frequent with preventive PCI compared with optimal medical therapy alone in both diabetic (0% vs. 3.7%; P = .004) and non-diabetic patients (0.5% vs. 3.2%; hazard ratio 0.16; 95% confidence interval 0.05-0.55; P = .004), without a significant interaction between diabetic status and randomized strategy. CONCLUSIONS: The risk of adverse clinical events was similar between diabetic and non-diabetic patients with non-flow-limiting vulnerable coronary plaques. However, preventive PCI was associated with a lower incidence of the primary endpoint at 2 years, regardless of diabetes status.

Auteurs: Min Chul Kim, Seung-Jung Park, Duk-Woo Park, Jung-Min Ahn, Do-Yoon Kang, Won-Jang Kim, Chang-Wook Nam, Jin-Ok Jeong, In-Ho Chae, Hiroki Shiomi, Hsien-Li Kao, Joo-Yong Hahn, Sung-Ho Her, Bong-Ki Lee, Tae Hoon Ahn, Kiyuk Chang, Jei Keon Chae, David Smyth, Gary S Mintz, Gregg W Stone, Youngkeun Ahn

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Bron: European heart journal, https://doi.org/10.1093/eurheartj/ehaf273. Bijgewerkt 2026-07-03T13:30:48Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.