Consensus document for invasive coronary physiologic assessment in Asia-Pacific countries

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology

Background:

• Invasive coronary physiology, including fractional flow reserve, is globally adopted but with varying rates.
• Significant differences in patient profiles and physician preferences exist in the Asia-Pacific (APAC) region regarding PCI strategies.
• A need exists for region-specific recommendations for physiology-guided PCI in APAC populations to optimize clinical outcomes.

Framework:

• A consensus document was developed based on a questionnaire for 20 interventional cardiologists across 10 APAC countries.
• Key recommendations were formulated by reviewing clinical evidence, techniques, and clinical scenarios for physiology-guided PCI.
• The 5E approach (Evidence, Education, Expand hardware, Economics, Expert consensus) was proposed to enhance the adoption of invasive physiology-based therapy.

Implementation:

• Recommendations focus on best practices for APAC populations to achieve consistent and optimal clinical outcomes.
• Suggestions include developing evidence for specific lesion and patient types, and future research in health economics and local data.
• Emphasis is placed on developing appropriate use criteria and educating all stakeholders involved in PCI.

Implications:

• This consensus supports interventional cardiologists, hospital administrators, patients, and device companies.
• It aims to build confidence and encourage wider implementation of invasive coronary physiology-guided therapy.
• The goal is to enhance the penetration of physiology-based treatment strategies in the APAC region.