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Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial A VOYAGER Meta-Analysis of the Impact of Statin Therapy on Low-Density Lipoprotein Cholesterol and Triglyceride Levels in Patients With Hypertriglyceridemia Effects of Aspirin for Primary Prevention in Persons with Diabetes Mellitus Atrial Fibrillation Burden: Moving Beyond Atrial Fibrillation as a Binary Entity: A Scientific Statement From the American Heart Association Spontaneous Coronary Artery Dissection: Current State of the Science: A Scientific Statement From the American Heart Association Predicting Major Adverse Events in Patients With Acute Myocardial Infarction Cardiac Troponin Elevation in Patients Without a Specific Diagnosis Association between urinary dickkopf-3, acute kidney injury, and subsequent loss of kidney function in patients undergoing cardiac surgery: an observational cohort study A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions Overall and Cause-Specific Mortality in Randomized Clinical Trials Comparing Percutaneous Interventions With Coronary Bypass Surgery: A Meta-analysis

Review Article2021 Feb, 14 (3) 237–246

JOURNAL:JACC: Cardiovascular Interventions Article Link

Invasive Coronary Physiology After Stent Implantation: Another Step Toward Precision Medicine

S Biscaglia , B Uretsky , E Barbato , C Collet et al. Keywords: intracoronary physiology; post PCI; functional assessment

ABSTRACT

Intracoronary physiology is routinely used in setting the indication for percutaneous coronary intervention (PCI) but seldom in assessing procedural results. This attitude is increasingly challenged by accumulated evidence demonstrating the value of post-PCI functional assessment in predicting long-term patient outcomes. Besides fractional flow reserve, a number of new indexes recently incorporated to clinical practice, including nonhyperemic pressure and functional angiographic indexes, provide new opportunities for the physiological assessment of PCI results. Largely, the benefit of these tools is derived from longitudinal analysis of the treated vessel, which allows precise identification of the vessel segment accounting for a suboptimal functional result and enabling operators to perform accurate PCI optimization. In this document the authors review available evidence supporting why physiological assessment should be extended to immediate post-PCI with the aim of improving patient outcomes. A step-by-step guide on how available physiological tools can be used for such purpose is provided.