An Evaluation of a Physiology-guided PCI Optimisation Strategy (Target-FFR)
Coronary Artery Disease, Coronary Stenosis
About this trial
This is an interventional treatment trial for Coronary Artery Disease focused on measuring FFR Targeted PCI, Post-PCI FFR, Physiology-guided PCI Optimisation
Eligibility Criteria
Inclusion Criteria:
- Patients >18 years of age with coronary artery disease (including stable angina and stabilised non-ST-elevation myocardial infarction (NSTEMI)) who are able to provide informed consent.
Exclusion Criteria:
- PCI in a coronary artery bypass graft
- PCI to an in-stent restenosis (ISR) lesion
- PCI to a target artery providing Rentrop grade 2 or 3 collateral blood supply to another vessel
- Inability to receive adenosine (for example, severe reactive airway disease, marked hypotension, or advanced atrioventricular block without pacemaker).
- Recent (within 1 week prior to cardiac catheterization) ST-segment elevation myocardial infarction (STEMI) in any arterial distribution (not specifically target lesion).
- Severe cardiomyopathy (ejection fraction <30%).
- Renal insufficiency such that an additional 20 to 30 mL of contrast would, in the opinion of the operator, pose unwarranted risk to the patient.
Sites / Locations
- Golden Jubilee National Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
PIOS Intervention Group
Control Group
Operator-blinded pre and post-PCI coronary physiology measurements will be recorded. If FFR is <0.90, the result will be disclosed to the operator and a hyperaemic pressure wire pullback will be performed during a standard peripheral intravenous adenosine infusion (140mcg/kg/min). The operator will then follow the PIOS protocol to attempt to obtain the target optimal post-PCI FFR result.
Operator-blinded pre and post-PCI coronary physiology measurements will be recorded and the angiographically defined result will be accepted.