Immediate post-procedural functional assessment of percutaneous coronary intervention: current evidence and future directions

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

DOI

  • Daixin Ding, National University of Ireland, Shanghai Jiao Tong University
  • ,
  • Jiayue Huang, National University of Ireland, Shanghai Jiao Tong University
  • ,
  • Jelmer Westra
  • David Joel Cohen, Division of Cardiology, Columbia University Medical Center, Cardiovascular Research Foundation, New York, New York.
  • ,
  • Yundai Chen, Department of Stomatology, Chinese PLA General Hospital, Beijing, China
  • ,
  • Birgitte Krogsgaard Andersen
  • Niels Ramsing Holm
  • Bo Xu, Chinese Academy of Medical Sciences & Peking Union Medical College
  • ,
  • Shengxian Tu, Shanghai Jiao Tong Univ, Shanghai Jiao Tong University, Shanghai Peoples Hosp 1, Dept Lab Med, Department of Cardiology, Fujian Medical University Union Hospital, Fuzhou, Fujian, China.
  • ,
  • William Wijns, National University of Ireland

Percutaneous coronary intervention (PCI) guided by coronary physiology provides symptomatic benefit and improves patient outcomes. Nevertheless, over one-fourth of patients still experience recurrent angina or major adverse cardiac events following the index procedure. Coronary angiography, the current workhorse for evaluating PCI efficacy, has limited ability to identify suboptimal PCI results. Accumulating evidence supports the usefulness of immediate post-procedural functional assessment. This review discusses the incidence and possible mechanisms behind a suboptimal physiology immediately after PCI. Furthermore, we summarize the current evidence base supporting the usefulness of immediate post-PCI functional assessment for evaluating PCI effectiveness, guiding PCI optimization, and predicting clinical outcomes. Multiple observational studies and post hoc analyses of datasets from randomized trials demonstrated that higher post-PCI functional results are associated with better clinical outcomes as well as a reduced rate of residual angina and repeat revascularization. As such, post-PCI functional assessment is anticipated to impact patient management, secondary prevention, and resource utilization. Pre-PCI physiological guidance has been shown to improve clinical outcomes and reduce health care costs. Whether similar benefits can be achieved using post-PCI physiological assessment requires evaluation in randomized clinical outcome trials.

OriginalsprogEngelsk
TidsskriftEuropean Heart Journal
Vol/bind42
Nummer27
Sider (fra-til)2695–2707
ISSN0195-668X
DOI
StatusUdgivet - jul. 2021

Bibliografisk note

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2021. For permissions, please email: journals.permissions@oup.com.

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