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Rodriguez-Leor O, Toledano B, López-Palop R, Rivero F, Brugaletta S, Linares JA, Benito T, Carrillo P, Puigfel M, Cediel G, Sadaba M, Vaquerizo B, Rondán J, Gómez I, Alfonso F, Sáez R, Planas A, Lozano F, Hernández F, Sabaté M, Ruíz-Arroyo JR, Torres F, de la Torre Hernández JM, Gutiérrez E, Cid-Álvarez AB, Díez JL, Fernández L, Moreu J, Ojeda S, Cerrato P, Ruiz-Quevedo V, Sanchis J, Gómez-Menchero A, Ocaranza R, Mohandes M, Hernández JM, Alfageme MM, Aguiar P, López Mínguez JR, Pérez de Prado A. 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. Cardiovasc Revasc Med 2023; 51:55-64. [PMID: 36822975 DOI: 10.1016/j.carrev.2023.01.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 12/27/2022] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
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.
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Affiliation(s)
- Oriol Rodriguez-Leor
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain; CIBER de Enfermedades CardioVasculares (CIBERCV) Instituto de Salud Carlos III, Madrid, Spain; Institut de Recerca en Ciències de la Salut Germans Trias i Pujol, Badalona, Spain.
| | - Beatriz Toledano
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | | | - Fernando Rivero
- Servicio de Cardiología, Hospital de la Princesa, Madrid, Spain
| | - Salvatore Brugaletta
- Servicio de Cardiología, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | | | - Tomás Benito
- Servicio de Cardiología, Hospital de León, León, Spain
| | - Pilar Carrillo
- Servicio de Cardiología, Hospital de Sant Joan, Alacant, Spain
| | - Martí Puigfel
- Servicio de Cardiología, Hospital Josep Trueta de Girona, Girona, Spain
| | - German Cediel
- Institut del Cor, Hospital Universitari Germans Trias i Pujol, Badalona, Spain
| | - Mario Sadaba
- Servicio de Cardiología, Hospital de Galdakao, Galdakao, Spain
| | | | - Juan Rondán
- Servicio de Cardiología, Hospital de Cabueñes, Gijón, Spain
| | - Iván Gómez
- Servicio de Cardiología, Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | - Roberto Sáez
- Servicio de Cardiología, Hospital de Basurto, Basurto, Spain
| | - Ana Planas
- Servicio de Cardiología, Hospital de Castellón, Castellón de la Plana, Spain
| | - Fernando Lozano
- Servicio de Cardiología, Hospital de Ciudad Real, Ciudad Real, Spain
| | - Felipe Hernández
- Servicio de Cardiología, Clínica Universitaria de Navarra, Madrid, Spain
| | - Manel Sabaté
- Servicio de Cardiología, Hospital Clínic i Provincial de Barcelona, Barcelona, Spain
| | | | | | | | - Enrique Gutiérrez
- Servicio de Cardiología, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - Ana Belén Cid-Álvarez
- Servicio de Cardiología, Hospital Clínico de Santiago, Santiago de Compostela, Spain
| | - José Luís Díez
- Servicio de Cardiología, Hospital Universitari de la Fe, Valencia, Spain
| | - Luis Fernández
- Servicio de Cardiología, Hospital de Cruces, Barakaldo, Spain
| | - José Moreu
- Servicio de Cardiología, Hospital de Toledo, Toledo, Spain
| | - Soledad Ojeda
- Servicio de Cardiología, Hospital Universitario Reina Sofía, Córdoba, Spain
| | - Pablo Cerrato
- Servicio de Cardiología, Hospital de Mérida, Mérida, Spain
| | | | - Juan Sanchis
- Servicio de Cardiología, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | | | | | - Mohsen Mohandes
- Servicio de Cardiología, Hospital Universitari Joan XXIII, Tarragona, Spain
| | | | | | - Pablo Aguiar
- Servicio de Cardiología, Hospital San Pedro de Logroño, Logroño, Spain
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