COMBINE (OCT-FFR), combined fractional flow reserve (FFR) and optical coherence tomography (OCT) to improve the accuracy of identifying high-risk lesions in patients with diabetes. Patients with diabetes, who had non-culprit target lesion(s) with 40-80% diameter stenosis and negative FFR, underwent OCT to determine the presence or absence of TCFA (thin-capped fibroatheroma). The primary endpoint – incidence of non-culprit lesion related major adverse cardiac events – occurred in 13.3 percent of the thin-cap fibroatheroma (TCFA), group compared with 3.1 percent of the TCFA-negative group, P=0.0004.   This small trial is thought-provoking and, similar to the PROSPECT II trial, provides a basis for a future larger randomized controlled trial to evaluate whether medical or interventional therapies can mitigate the risk associated with the presence of “high risk” non-culprit lesions