Filippo CreaInstitute of Cardiology

Catholic University of the Sacred HeartRome, Italy

COVADISPost PCI angina

Prevalence of angina after PCIStudy Study design Patients with angina post-PCI Follow up time

(months)

COURAGE 1 RCT comparing PCI vs OMT 34% 12

ARTS 12 RCT comparing PCI with BMS vs CABG 21% 12

ABSORB III 15RCT comparing PCI with EES vs PCI with

BVS18.4% in EES group, 18.3% in BVS group 12

SYNTAX 16 RCT comparing PCI vs CABG 28.5% 12

FAME 18RCT comparing FFR-guided vs

angio-guided PCI19% in FFR group, 22% in angio group 12

NHLBI Dynamic Registry 14 Registry 20% 12

Ben-Yehuda 19 Registry 28% 12

(Fanaroff et al, EHJ 2019)

(Crea et al, EHJ 2018)

Structural and functional alterations of persistent/recurrent angina after PCI

Coronary microvascular dysfunction after elective PCI: correlation with exercise stress test results (n=29, positive EST in 11)

(Milo et al, Int J Cardiol 2013)

(Ong P et al, Clin Res Cardiol 2014)

Coronary vasomotion disorders of epicardialarteries and microcirculation after pci

Assessment of the mechanisms of persistence or recurrence of angina after PCI in the cath lab

(Crea et al, EHJ 2019)

Diagnostic evaluation of recurrent/persistent angina following percutaneous coronary revascularisation

(Crea et al, EHJ 2019)

Impact of CMD on outcome in patientswith SA (n=178)

(van de Hoef et al, Circulation Cardiov Int2013)

Impact of CMD on outcome in patientswith STEMI (n=100)

(van de Hoef et al, Circulation Cardiov Int 2013)

Epicardial and microvascular spasm after PCI

(Crea et al, EHJ 2019)

Potential benefit of revascularizationfor low CFR

(Taqueti et al, Circulation 2015)

Questions for the panel• How to predict which patients will have

symptomatic and prognostic benefit from PCI prior to the procedure?

• How to prove that the diagnostic work up proposed by COVADIS improvespatient treatment?