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Comparison of different guidance strategies to percutaneous coronary intervention: A network meta-analysis of randomized clinical trials.
Int J Cardiol
December 2024
Cardiothoracic and Vascular Department (DICATOV), IRCCS Ospedale Policlinico San Martino, Genova, Italy.
Article Synopsis
- The study evaluates various techniques for guiding percutaneous coronary intervention (PCI) to determine which yields the best patient outcomes.
- It analyzes data from 39 randomized trials involving over 29,000 patients, highlighting that intravascular imaging (like OCT and IVUS) and physiology-guided strategies (like FFR) significantly reduce cardiac death compared to traditional coronary angiography (CA).
- Overall, the results suggest that OCT is the most effective guidance method, leading to lower rates of myocardial infarction, stent thrombosis, and all-cause mortality compared to CA.
QFR for the Revascularization of Nonculprit Vessels in MI Patients: Insights From the FIRE Trial.
JACC Cardiovasc Interv
June 2024
Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Ferrara, Italy.
Background: The role of quantitative flow ratio (QFR) in the treatment of nonculprit vessels of patients with myocardial infarction (MI) is a topic of ongoing discussion.
Objectives: This study aimed to investigate the predictive capability of QFR for adverse events and its noninferiority compared to wire-based functional assessment in nonculprit vessels of MI patients.
Methods: The FIRE (Functional Assessment in Elderly MI Patients With Multivessel Disease) trial randomized 1,445 older MI patients to culprit-only (n = 725) or physiology-guided complete revascularization (n = 720).
Efficacy of "Physiology-Guided PCI" Using Pressure Catheter in Comparison to Conventional Pressure Wires: A Multicenter Analysis.
Am J Cardiol
March 2024
Diagnostic and Interventional Cardiology Unit, Center of Excellence in Cardiovascular Sciences, Ospedale Isola Tiberina - Gemelli Isola Roma, Italia; Department of Cardiovascular and Pneumological Sciences, Università Cattolica del Sacro Cuore, Roma, Italia; Department of Cardiovascular Sciences, Fondazione Policlinico Agostino Gemelli IRCCS, Roma, Italy. Electronic address:
Coronary Physiology Guidance vs Conventional Angiography for Optimization of Percutaneous Coronary Intervention: The AQVA-II Trial.
JACC Cardiovasc Interv
January 2024
Cardiology Unit, Azienda Ospedaliero Universitaria di Ferrara, Cona, Italy.
Background: The debate surrounding the efficacy of coronary physiological guidance compared with conventional angiography in achieving optimal post-percutaneous coronary intervention (PCI) fractional flow reserve (FFR) values persists.
Objectives: The primary aim of this study was to demonstrate the superiority of physiology-guided PCI, using either angiography or microcatheter-derived FFR, over conventional angiography-based PCI in complex high-risk indicated procedures (CHIPs). The secondary aim was to establish the noninferiority of angiography-derived FFR guidance compared with microcatheter-derived FFR guidance.
Background: The role of percutaneous coronary interventions (PCI) in patients with diabetes mellitus and multi-vessel disease has been questioned by the results of the FREEDOM trial, which showed superiority of coronary artery bypass graft(CABG) over first generation drug-eluting stents (DES) including a reduction in mortality. In the light of safer and more efficacious stents and significantly better medical management, those results that date back to 2012 need to be revisited. TUXEDO-2 is a study designed to compare two contemporary stents in Indian diabetic patients with multi-vessel disease.
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