Randomized Study Comparing Angiography Guidance With Physiology Guidance After PCI: The EASY-PREDICT Study.

Area of Science:

• Cardiology
• Interventional Cardiology
• Physiology

Background:

• Physiology assessment using pressure ratios before percutaneous coronary intervention (PCI) guides treatment decisions.
• The benefit of post-PCI physiology assessment over standard angiography guidance is not well-established.

Purpose of the Study:

• To investigate if post-PCI physiology assessment improves clinical outcomes compared to angiography-guided PCI.

Main Methods:

• Patients undergoing PCI were randomized to either angiography guidance or physiology guidance (including nonhyperemic pressure ratio and fractional flow reserve).
• The primary outcome was target vessel failure at 18 months, with secondary outcomes including angina scores and quality of life.

Main Results:

• No significant difference in target vessel failure rates (17.4% vs. 18%, P=0.88) was observed between the angiography and physiology groups.
• Cardiac death, myocardial infarction, and target vessel revascularization rates were similar between the groups.
• No differences were found in angina scores, medication use, or quality of life.

Conclusions:

• Routine post-PCI physiology assessment did not demonstrate clinical benefit compared to standard angiographic guidance in all-comers patients.
• Further studies are warranted to explore the utility of post-PCI physiology in select patient or lesion subsets.