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Symposia & Webinars

Controlling angina – The 2 sides of the PCI coin

 

The presentation addresses different questions and related data for the analysis of PCI:

  • Why do we perform PCI to treat angina?
    • PCI improves angina by treating flow limiting stenosis
  • Is PCI better than antianginal medication?
    • ISCHEMIA trial (impact of an invasive strategy on angina pectoris)
  • How good is PCI in relieving angina in available PCI studies?
    • ABSORB IV trial (angina through 1-year follow up)
    • MR-INFORM trial
    • Post-PCI angina and procedural developments
  • Is PCI superior to CABG in relieving angina?
    • SYNTAX study about angina frequency (SAQ) with PCI or CABG, also at 5 year FU
  • What may cause post-PCI angina?
    • Post-PCI ischemia may an obstructive or non -obstructive cause
    • Residual SS/functional residual score on long-term outcomes
    • DEFINE PCI: blinded analysis of post-PCI results and 1-year clinical outcomes
    • HAWAKEYE trial: relevance of residual stenoses after PCI
    • TARGER FFR trial: post PCI FFR values and optimization strategy
    • PIOS (Physiology-guided Incremental Optimization Strategy)
  • May post-PCI angina have a non-obstructive origin?
    • Pre-existing microvascular dysfunction and PCI results
    • Vasomotor disorders after stent implantation

Key messages include:

  • PCI is a suboptimal treatment for angina in stable patients
  • Potentially, the two more relevant causes of post-PCI angina are:
    • Residual obstructive disease and
    • Non-obstructive causes of myocardial ischemia
  • Future research should clarify the best approach to manage these causes:
    • Simulation/prediction of functional PCI results to plan intervention
    • Assessment to final functional results of PCI followed by optimization strategies
    • Pre-PCI assessment of obstructive and non-obstructive causes of ischemia

This video is part of the webinar “Why we need a paradigm shift in the treatment of CCS?” held virtually by Servier on December 11th, 2020.

View also the other part of the webinar: