Investigating Advanced Invasive Diagnosis to Identify Causes of Angina After PCI in Stable Coronary Syndrome Patients

What this Trial Is About

This observational, prospective study focuses on patients with post-percutaneous coronary intervention PCI angina who are referred for invasive coronary angiography ICA. It aims to identify the causes and origins of post-PCI angina using an advanced invasive diagnosis AID strategy combined with angiography derived physiology ADP. The study includes patients with a history of PCI who present angina or documented myocardial ischemia, investigating both obstructive and non-obstructive causes of ischemia. Participants undergo ICA with the structured AID strategy, starting with coronary angiography to evaluate severe-grade stenosis. Intermediate-grade stenosis is further assessed using fractional flow reserve FFR and non-hyperaemic pressure ratios NHPR. Patients with non-obstructive coronary artery disease or normal arteries undergo tests for microcirculatory and vasomotor disorders. ADP is applied using specialized software to analyze coronary angiograms from both the current and previous procedures. Treatment decisions are made by clinicians based on these assessments. Patients complete the Seattle Angina Questionnaire SAQ at baseline and at 1, 6, and 12 months after the procedure to evaluate angina symptoms. The main outcome is the proportion of patients in whom the origins of obstructive disease and causes of post-PCI angina are identified. The study also measures angina symptom improvement at 6 months. Follow-up includes clinical evaluations and symptom questionnaires to monitor outcomes over one year.

Advanced Invasive Diagnosis Strategy for Post-PCI Patients With Stable Coronary Syndromes Undergoing Coronary Angiography