Changes in the treatment strategy following intracoronary pressure wire in a contemporaneous real-life cohort of patients with intermediate coronary stenosis. results from a nationwide registry

Rodriguez-Leor, Oriol ; Toledano, Beatriz ; López-Palop, Ramón ; Rivero, Fernando ; Brugaletta, Salvatore ; Linares, José Antonio (Universidad de Zaragoza) ; Benito, Tomás ; Carrillo, Pilar ; Puigfel, Martí ; Cediel, German ; Sadaba, Mario ; Vaquerizo, Beatriz ; Rondán, Juan ; Gómez, Iván ; Alfonso, Fernando ; Sáez, Roberto ; Planas, Ana ; Lozano, Fernando ; Hernández, Felipe ; Sabaté, Manel ; Ruíz-Arroyo, José Ramón ; Torres, Francisco ; de la Torre Hernández, José María ; Gutiérrez, Enrique ; Cid-Álvarez, Ana Belén ; Díez, José Luís ; Fernández, Luis ; Moreu, José ; Ojeda, Soledad ; Cerrato, Pablo ; Ruiz-Quevedo, Valeriano ; Sanchis, Juan ; Gómez-Menchero, Antonio ; Ocaranza, Raymundo ; Mohandes, Mohsen ; Hernández, José María ; Alfageme, Miren Maite ; Aguiar, Pablo ; López Mínguez, José Ramón ; Pérez de Prado, Armando

Resumen: Background
Intracoronary pressure wire is useful to guide revascularization in patients with coronary artery disease.
Aims
To evaluate changes in diagnosis (coronary artery disease extent), treatment strategy and clinical results after intracoronary pressure wire study in real-life patients with intermediate coronary artery stenosis.
Methods
Observational, prospective and multicenter registry of patients in whom pressure wire was performed. The extent of coronary artery disease and the treatment strategy based on clinical and angiographic criteria were recorded before and after intracoronary pressure wire guidance. 12-month incidence of MACE (cardiovascular death, non-fatal myocardial infarction or new revascularization of the target lesion) was assessed.
Results
1414 patients with 1781 lesions were included. Complications related to the procedure were reported in 42 patients (3.0 %). The extent of coronary artery disease changed in 771 patients (54.5 %). There was a change in treatment strategy in 779 patients (55.1 %) (18.0 % if medical treatment; 68.8 % if PCI; 58.9 % if surgery (p < 0.001 for PCI vs medical treatment; p = 0.041 for PCI vs CABG; p < 0.001 for medical treatment vs CABG)). In patients with PCI as the initial strategy, the change in strategy was associated with a lower rate of MACE (4.6 % vs 8.2 %, p = 0.034).
Conclusions
The use of intracoronary pressure wire was safe and led to the reclassification of the extent of coronary disease and change in the treatment strategy in more than half of the cases, especially in patients with PCI as initial treatment.

Idioma: Inglés

DOI: 10.1016/j.carrev.2023.01.027

Año: 2023

Publicado en: Cardiovascular revascularization medicine 51 (2023), 55-64
ISSN: 1553-8389

Factor impacto CITESCORE: 3.3 - Cardiology and Cardiovascular Medicine (Q2)

Factor impacto SCIMAGO: 0.493 - Medicine (miscellaneous) (Q3) - Cardiology and Cardiovascular Medicine (Q3)

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Medicina (Dpto. Medicina, Psiqu. y Derm.)