CT-Guided PCI Planning Shows Non-Inferiority to IVUS for One-Year Outcomes in P4 Trial

Results from the 1,105-patient P4 randomized clinical trial, presented at TCT 2026 and simultaneously published in the New England Journal of Medicine (NEJM), demonstrated that CT-guided percutaneous coronary intervention (PCI) planning was non-inferior to intravascular ultrasound (IVUS) for one-year clinical outcomes. The study also showed that CT guidance significantly improved procedural efficiency, leading to faster procedure times and lower contrast volume compared to IVUS. Data from the NAVIGATE-PCI registry further indicated that interventional cardiologists altered their procedural strategy in approximately 70% of cases after incorporating 3D anatomic, plaque, and physiologic insights from Heartflow PCI Navigator.