{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T19:24:54Z","timestamp":1789500294427,"version":"build-2803163510"},"reference-count":29,"publisher":"Oxford University Press (OUP)","issue":"32","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100019657","name":"CardioVascular Research Foundation, Abbott, Yuhan Corp., CAH-Cordis, Philips, and Infraredx, a Nipro Company","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019657","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,21]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background and Aims<\/jats:title>\n                  <jats:p>The efficacy and safety of preventive percutaneous coronary intervention (PCI) for treating vulnerable plaques in diabetic patients remain unclear.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>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 &amp;gt;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.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>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\u20132.14); 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\u20130.55; P = .004), without a significant interaction between diabetic status and randomized strategy.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>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.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehaf273","type":"journal-article","created":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T12:44:39Z","timestamp":1748522679000},"page":"3181-3197","source":"Crossref","is-referenced-by-count":11,"title":["Preventive percutaneous coronary intervention for non-flow-limiting vulnerable atherosclerotic coronary plaques in diabetes: the PREVENT trial"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6026-1702","authenticated-orcid":false,"given":"Min Chul","family":"Kim","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital , 42 Jebong-ro, Dong-gu, Gwangju ,","place":["South Korea"]},{"name":"Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School , 160 Baekseo-ro, Dong-gu, Gwangju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Jung","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88, Olymic-ro-43-gil, Songpa-gu, Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6643-0239","authenticated-orcid":false,"given":"Duk-Woo","family":"Park","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88, Olymic-ro-43-gil, Songpa-gu, Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Min","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88, Olymic-ro-43-gil, Songpa-gu, Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Do-Yoon","family":"Kang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine , 88, Olymic-ro-43-gil, Songpa-gu, Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Jang","family":"Kim","sequence":"additional","affiliation":[{"name":"Division of Cardiology, CHA University School of Medicine, CHA Ilsan Medical Center , Goyang ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chang-Wook","family":"Nam","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Keimyung University Dongsan Hospital , Daegu ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Ok","family":"Jeong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Chungnam National University Hospital , Daejeon ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In-Ho","family":"Chae","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Seoul National University Bundang Hospital , Sungnam ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7234-023X","authenticated-orcid":false,"given":"Hiroki","family":"Shiomi","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Kyoto University Hospital , Kyoto ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hsien-Li","family":"Kao","sequence":"additional","affiliation":[{"name":"Division of Cardiology, National Taiwan University Hospital , Taipei ,","place":["Taiwan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joo-Yong","family":"Hahn","sequence":"additional","affiliation":[{"name":"Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung-Ho","family":"Her","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Saint Vincent\u2019s Hospital , Suwon ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bong-Ki","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Kangwon National University Hospital , Chuncheon ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Hoon","family":"Ahn","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Na-Eun Hospital , Incheon ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyuk","family":"Chang","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Seoul Saint Mary\u2019s Hospital, Catholic University of Korea , Seoul ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jei Keon","family":"Chae","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Jeonbuk National University Hospital , Jeonju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Smyth","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Christchurch Hospital , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary S","family":"Mintz","sequence":"additional","affiliation":[{"name":"Cardiovascular Research Foundation , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregg W","family":"Stone","sequence":"additional","affiliation":[{"name":"The Zena and Michael A Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai , New York, NY ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2022-9366","authenticated-orcid":false,"given":"Youngkeun","family":"Ahn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Chonnam National University Hospital , 42 Jebong-ro, Dong-gu, Gwangju ,","place":["South Korea"]},{"name":"Division of Cardiology, Department of Internal Medicine, Chonnam National University Medical School , 160 Baekseo-ro, Dong-gu, Gwangju ,","place":["South Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,5,29]]},"reference":[{"key":"2025101322573837900_ehaf273-B1","doi-asserted-by":"publisher","first-page":"2215","DOI":"10.1016\/S0140-6736(10)60484-9","article-title":"Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies","volume":"375","author":"Sarwar","year":"2010","journal-title":"Lancet"},{"key":"2025101322573837900_ehaf273-B2","doi-asserted-by":"publisher","first-page":"829","DOI":"10.1056\/NEJMoa1008862","article-title":"Diabetes mellitus, fasting glucose, and risk of cause-specific death","volume":"364","author":"Rao Kondapally Seshasai","year":"2011","journal-title":"N Engl J Med"},{"key":"2025101322573837900_ehaf273-B3","doi-asserted-by":"publisher","first-page":"1720","DOI":"10.1056\/NEJMoa1504347","article-title":"Excess mortality among persons with type 2 diabetes","volume":"373","author":"Tancredi","year":"2015","journal-title":"N Engl J Med"},{"key":"2025101322573837900_ehaf273-B4","doi-asserted-by":"publisher","first-page":"e009245","DOI":"10.1161\/JAHA.118.009245","article-title":"Coronary plaque characteristics in patients with diabetes mellitus who presented with acute coronary syndromes","volume":"7","author":"Sugiyama","year":"2018","journal-title":"J Am Heart Assoc"},{"key":"2025101322573837900_ehaf273-B5","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1161\/ATVBAHA.116.306256","article-title":"Pathology of human coronary and carotid artery atherosclerosis and vascular calcification in diabetes mellitus","volume":"37","author":"Yahagi","year":"2017","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2025101322573837900_ehaf273-B6","doi-asserted-by":"publisher","first-page":"1675","DOI":"10.1161\/CIRCULATIONAHA.113.002114","article-title":"Coronary artery revascularization in patients with diabetes mellitus","volume":"128","author":"Armstrong","year":"2013","journal-title":"Circulation"},{"key":"2025101322573837900_ehaf273-B7","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1016\/j.jcmg.2008.10.017","article-title":"Plaque characteristics in culprit lesions and inflammatory status in diabetic acute coronary syndrome patients","volume":"2","author":"Hong","year":"2009","journal-title":"JACC Cardiovasc Imaging"},{"key":"2025101322573837900_ehaf273-B8","doi-asserted-by":"publisher","first-page":"1685","DOI":"10.1056\/NEJMra043430","article-title":"Inflammation, atherosclerosis, and coronary artery disease","volume":"352","author":"Hansson","year":"2005","journal-title":"N Engl J Med"},{"key":"2025101322573837900_ehaf273-B9","doi-asserted-by":"publisher","first-page":"4923","DOI":"10.1093\/eurheartj\/ehac533","article-title":"Plaque histology and myocardial disease in sudden coronary death: the Fingesture study","volume":"43","author":"Holmstr\u00f6m","year":"2022","journal-title":"Eur Heart J"},{"key":"2025101322573837900_ehaf273-B10","doi-asserted-by":"publisher","first-page":"1013","DOI":"10.1001\/jamacardio.2023.2910","article-title":"Fractional flow reserve-negative high-risk plaques and clinical outcomes after myocardial infarction","volume":"8","author":"Mol","year":"2023","journal-title":"JAMA Cardiol"},{"key":"2025101322573837900_ehaf273-B11","doi-asserted-by":"publisher","first-page":"4671","DOI":"10.1093\/eurheartj\/ehab433","article-title":"Thin-cap fibroatheroma predicts clinical events in diabetic patients with normal fractional flow reserve: the COMBINE OCT-FFR trial","volume":"42","author":"Kedhi","year":"2021","journal-title":"Eur Heart J"},{"key":"2025101322573837900_ehaf273-B12","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 ESC\/EACTS Guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur Heart J"},{"key":"2025101322573837900_ehaf273-B13","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1161\/CIR.0000000000001038","article-title":"2021 ACC\/AHA\/SCAI Guideline for coronary artery revascularization: a report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"145","author":"Lawton","year":"2022","journal-title":"Circulation"},{"key":"2025101322573837900_ehaf273-B14","doi-asserted-by":"publisher","first-page":"2289","DOI":"10.1016\/j.jacc.2020.09.547","article-title":"Percutaneous coronary intervention for vulnerable coronary atherosclerotic plaque","volume":"76","author":"Stone","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2025101322573837900_ehaf273-B15","doi-asserted-by":"publisher","first-page":"e011728","DOI":"10.1161\/CIRCINTERVENTIONS.121.011728","article-title":"Thin-cap fibroatheroma rather than any lipid plaques increases the risk of cardiovascular events in diabetic patients: insights from the COMBINE OCT-FFR trial","volume":"15","author":"Fabris","year":"2022","journal-title":"Circ Cardiovasc Interv"},{"key":"2025101322573837900_ehaf273-B16","doi-asserted-by":"publisher","first-page":"e1099","DOI":"10.4244\/EIJ-D-22-00306","article-title":"Long-term outcomes of patients with normal fractional flow reserve and thin-cap fibroatheroma","volume":"18","author":"Fabris","year":"2023","journal-title":"EuroIntervention"},{"key":"2025101322573837900_ehaf273-B17","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1093\/ehjci\/jeac218","article-title":"Morphological characteristics of lesions with thin cap fibroatheroma\u2013a substudy from the COMBINE (OCT-FFR) trial","volume":"24","author":"Roleder-Dylewska","year":"2023","journal-title":"Eur Heart J Cardiovasc Imaging"},{"key":"2025101322573837900_ehaf273-B18","doi-asserted-by":"publisher","first-page":"e707","DOI":"10.4244\/EIJ-D-23-00628","article-title":"Vulnerable plaque features and adverse events in patients with diabetes mellitus: a post hoc analysis of the COMBINE OCT-FFR trial","volume":"20","author":"Del Val","year":"2024","journal-title":"EuroIntervention"},{"key":"2025101322573837900_ehaf273-B19","doi-asserted-by":"publisher","first-page":"1753","DOI":"10.1016\/S0140-6736(24)00413-6","article-title":"Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial","volume":"403","author":"Park","year":"2024","journal-title":"Lancet"},{"key":"2025101322573837900_ehaf273-B20","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1016\/j.ahj.2023.05.017","article-title":"Preventive PCI or medical therapy alone for vulnerable atherosclerotic coronary plaque: rationale and design of the randomized, controlled PREVENT trial","volume":"264","author":"Ahn","year":"2023","journal-title":"Am Heart J"},{"key":"2025101322573837900_ehaf273-B21","doi-asserted-by":"publisher","first-page":"1749","DOI":"10.1161\/CIR.0000000000000095","article-title":"2014 ACC\/AHA\/AATS\/PCNA\/SCAI\/STS focused update of the guideline for the diagnosis and management of patients with stable ischemic heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines, and the American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons","volume":"130","author":"Fihn","year":"2014","journal-title":"Circulation"},{"key":"2025101322573837900_ehaf273-B22","doi-asserted-by":"publisher","first-page":"e1082","DOI":"10.1161\/CIR.0000000000000625","article-title":"2018 AHA\/ACC\/AACVPR\/AAPA\/ABC\/ACPM\/ADA\/AGS\/APhA\/ASPC\/NLA\/PCNA Guideline on the Management of Blood Cholesterol: a report of the American College of Cardiology\/American Heart Association Task Force on Clinical Practice Guidelines","volume":"139","author":"Grundy","year":"2019","journal-title":"Circulation"},{"key":"2025101322573837900_ehaf273-B23","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1093\/eurheartj\/ehz425","article-title":"2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes","volume":"41","author":"Knuuti","year":"2020","journal-title":"Eur Heart J"},{"key":"2025101322573837900_ehaf273-B24","doi-asserted-by":"publisher","first-page":"1150","DOI":"10.1016\/j.jcin.2012.06.019","article-title":"Comparison of nonculprit coronary plaque characteristics between patients with and without diabetes: a 3-vessel optical coherence tomography study","volume":"5","author":"Kato","year":"2012","journal-title":"JACC Cardiovasc Interv"},{"key":"2025101322573837900_ehaf273-B25","doi-asserted-by":"publisher","first-page":"473","DOI":"10.1007\/s10554-021-02297-x","article-title":"Relationship between hemoglobin A1C and characteristics of plaque vulnerability in stable coronary disease: an optical coherence tomography study","volume":"38","author":"Ueyama","year":"2022","journal-title":"Int J Cardiovasc Imaging"},{"key":"2025101322573837900_ehaf273-B26","doi-asserted-by":"publisher","first-page":"388","DOI":"10.1016\/j.jcin.2020.10.008","article-title":"Hemoglobin A1c and cardiovascular outcomes following percutaneous coronary intervention: insights from a large single-center registry","volume":"14","author":"Baber","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"key":"2025101322573837900_ehaf273-B27","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1016\/S0140-6736(24)00282-4","article-title":"Intravascular ultrasound-guided versus angiography-guided percutaneous coronary intervention in acute coronary syndromes (IVUS-ACS): a two-stage, multicentre, randomised trial","volume":"403","author":"Li","year":"2024","journal-title":"Lancet"},{"key":"2025101322573837900_ehaf273-B28","doi-asserted-by":"publisher","first-page":"824","DOI":"10.1016\/S0140-6736(23)02454-6","article-title":"Intravascular imaging-guided coronary drug-eluting stent implantation: an updated network meta-analysis","volume":"403","author":"Stone","year":"2024","journal-title":"Lancet"},{"key":"2025101322573837900_ehaf273-B29","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s12933-019-0944-8","article-title":"Relationships of coronary culprit-plaque characteristics with duration of diabetes mellitus in acute myocardial infarction: an intravascular optical coherence tomography study","volume":"18","author":"Sheng","year":"2019","journal-title":"Cardiovasc Diabetol"}],"container-title":["European Heart Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/46\/32\/3181\/63396984\/ehaf273.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurheartj\/article-pdf\/46\/32\/3181\/63396984\/ehaf273.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,14]],"date-time":"2025-10-14T02:58:55Z","timestamp":1760410735000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurheartj\/article\/46\/32\/3181\/8152672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,29]]},"references-count":29,"journal-issue":{"issue":"32","published-online":{"date-parts":[[2025,5,29]]},"published-print":{"date-parts":[[2025,8,21]]}},"URL":"https:\/\/doi.org\/10.1093\/eurheartj\/ehaf273","relation":{},"ISSN":["0195-668X","1522-9645"],"issn-type":[{"value":"0195-668X","type":"print"},{"value":"1522-9645","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,8,21]]},"published":{"date-parts":[[2025,5,29]]}}}