Background: Currently, invasive physiologic assessment such as fractional flow reserve is widely used worldwide with different adoption rates around the globe. Patient characteristics and physician preferences often differ in the Asia-Pacific (APAC) region with respect to treatment strategy, techniques, lesion complexity, access to coronary physiology and imaging devices, as well as patient management. Thus, there is a need to construct a consensus document on recommendations for use of physiology-guided percutaneous coronary intervention (PCI) in APAC populations. This document serves as an overview of recommendations describing the best practices for APAC populations to achieve more consistent and optimal clinical outcomes.
Methods and Results: A comprehensive multiple-choice questionnaire was provided to 20 interventional cardiologists from 10 countries in the APAC region. Clinical evidence, tips and techniques, and clinical situations for the use of physiology-guided PCI in APAC were reviewed and used to propose key recommendations. There are suggestions to continue to develop evidence for lesion and patient types that will benefit from physiology, develop directions for future research in health economics and local data, develop appropriate use criteria in different countries, and emphasize the importance of education of all stakeholders. A consensus recommendation to enhance the penetration of invasive physiology-based therapy was to adopt the 5E approach: Evidence, Education, Expand hardware, Economics and Expert consensus.
Conclusions: This consensus document and recommendations support interventional fellows and cardiologists, hospital administrators, patients, and medical device companies to build confidence and encourage wider implementation of invasive coronary physiology-guided therapy in the APAC region.
[1]Seoul Natl Univ Hosp, Dept Internal Med, Seoul, South Korea;
[2]Seoul Natl Univ Hosp, Ctr Cardiovasc, Seoul, South Korea;
[3]Sungkyunkwan Univ, Div Cardiol, Dept Internal Med, Heart Vasc Stroke Inst,Samsung Med Ctr,Sch Med, Seoul, South Korea;
[4]Keimyung Univ, Dept Med, Dongsan Med Ctr, Daegu, South Korea;
[5]Univ Ulsan, Dept Cardiol, Ulsan Univ Hosp, Coll Med, Ulsan, South Korea;
[6]Inje Univ, Dept Med, Ilsan Paik Hosp, Goyang, South Korea;
[7]Fudan Univ, Dept Cardiol, Shanghai Inst Cardiovasc Dis, Zhongshan Hosp, Shanghai, Peoples R China;
[8]Royal Prince Alfred Hosp, Dept Cardiol, Camperdown, NSW, Australia;
[9]Concord Hosp, Dept Cardiol, Sydney, NSW, Australia;
[10]Mahidol Univ, Siriraj Hosp, Div Cardiol, Bangkok, Thailand;
[11]Madras Med Mission, Inst Cardiovasc Dis, Chennai, Tamil Nadu, India;
[12]Lisie Hosp, Kochi, Kerala, India;
[13]Medanta, Gurgaon, India;
[14]Mackay Mem Hosp, Div Cardiol, Dept Internal Med, Taitung Branch, Taitung, Taiwan;
[15]Chinese Peoples Liberat Army Gen Hosp, Dept Cardiol, Beijing, Peoples R China;
[16]Guangdong Acad Med Sci, Guangdong Prov Key Lab Coronary Heart Dis Prevent, Guangdong Cardiovasc Inst, Guangdong Gen Hosp, Guangzhou, Guangdong, Peoples R China;
[17]Univ Hong Kong, Div Cardiol, Dept Med, Queen Mary Hosp, Hong Kong, Peoples R China;
[18]UTHealth, McGovern Med Sch, Houston, TX USA;
[19]Mem Hermann Hosp, Houston, TX USA
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