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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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The year in review: advances in interventional cardiology in 2019

Keyvan Karimi Galougahi1,2,3, Gregory Petrossian4, Gregg W Stone4,5

  • 1Department of Cardiology, Royal Prince Alfred Hospital and University of Sydney.

Current Opinion in Cardiology
|May 16, 2020
PubMed

Insights

Major studies in 2019 advanced interventional cardiology, showing pharmaco-invasive management is key for coronary artery disease. Revascularization improves quality of life and angina relief in stable ischemic heart disease.

Area of Science:

  • Interventional Cardiology
  • Cardiovascular Medicine
  • Clinical Practice Guidelines

Background:

  • Recent advancements in interventional cardiology have significantly impacted evidence-based knowledge.
  • Key areas include stable ischemic heart disease (SIHD), acute coronary syndromes, and interventional devices.

Purpose of the Study:

  • To review major studies from 2019 in interventional cardiology.
  • To highlight findings on pharmaco-invasive management of coronary artery disease.
  • To summarize the impact of these trials on clinical practice.

Main Methods:

  • Review of recent randomized studies in interventional cardiology.
  • Analysis of trials focusing on revascularization versus medical treatment.
  • Evaluation of data on interventional devices, pharmacotherapy, and intravascular guidance.

Main Results:

  • SIHD patients with moderate ischemia have similar event-free survival with conservative or invasive strategies.
  • Revascularization significantly improves quality of life and reduces angina in SIHD.
  • Percutaneous coronary intervention (PCI) and coronary artery bypass grafting show similar 5-year outcomes for left main coronary artery disease.
  • Conservative management is as effective as invasive approach for out-of-hospital cardiac arrest without ongoing ischemia.
  • Staged complete revascularization benefits ST-segment elevation myocardial infarction patients with multivessel disease.
  • P2Y12 inhibitor monotherapy is safe and effective for post-PCI atrial fibrillation patients on anticoagulation.
  • Intravascular imaging guidance improves post-PCI outcomes.

Conclusions:

  • Pharmaco-invasive strategies are crucial in managing coronary artery disease.
  • Revascularization offers significant benefits in quality of life and symptom relief for SIHD patients.
  • Intravascular imaging should be increasingly utilized to improve post-PCI outcomes.
Abstract

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