Procedural and Intracoronary Physiology Characteristics
Angioplasty, angina, pre-PCI, Coronary microvascular dysfunction, Post-PCI, post-PCI angina, coronary artery disease
STABLE ANGINA, CORONARY ARTERY DISEASE, CORONARY MICROVASCULAR DYSFUNCTION
There were no significant differences between groups in angiography-based parameters of coronary artery disease severity either pre- or post-PCI. Counterintuitively, patients with post-PCI angina had a higher burden of angina at baseline yet physiologically less severe lesions (significantly higher pre-PCI FFR and CFR values and faster hyperemic transit times) than those who were angina-free at follow-up. There were no differences in absolute post-PCI physiology values between groups, and among patients with angina at baseline, there was no correlation between post-PCI values and patient-reported outcome measures at follow-up. Coronary microvascular dysfunction has been proposed as a potential mechanism for persistent angina post-PCI.A physiology-stratified analysis of the ORBITA trial (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) assessed paired SAQ and EQ-5D-5L data from 189 patients and found that pre-PCI FFR and the instantaneous wave-free ratio (iFR) did not predict the effect of placebo-controlled PCI on anginal symptoms or quality of life.In the present analysis, among patients who had angina at baseline (CCS class I and above), pre-PCI, absolute and percentage delta FFR values had significant correlations with patient-reported outcome measures at follow-up. Post-PCI values had no correlation with angina or quality of life at follow-up indicating that, as demonstrated in the Figure and 