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Application of intravascular physiology methods in clinical practice: two-year data from the Russian registry

https://doi.org/10.15829/1560-4071-2024-5622

EDN: YUWLSY

Abstract

Aim. To analyze the use in clinical practice of intravascular coronary assessment methods based on two-year data from the Russian Registry on the Use of Intravascular Imaging and Physiology.

Material and methods. Since 2021, the Russian Registry on the Use of Intravascular Imaging and Physiology has included data from 7967 studies in 3932 patients, of which 3086 (38,7%) were studies of intravascular physiology. In 2021, 13 branches from 9 cities participated in the registry, in 2022 — 20 branches from 11 cities. For chronic coronary artery disease, 2484 (80,5%) studies were performed, for acute coronary syndrome (ACS) — 598 (19,4%).

Results. In 2022, the registry included 1,9 times more intravascular functional studies compared to 2021. The contribution of different clinics was uneven — 75,7% of studies were performed in three departments. The use of non-hyperemic indexes prevailed over hyperemic ones (58%), and in ACS they were used three times more often. All coronary arteries were examined, most often the anterior descending artery. As a primary diagnosis, 1968 (63,8%) studies were performed, while for the purpose of dynamic control — 122 (3,9%), at the surgical stage — 996 (32,3%). In 85,5% (n=2638) of observations, the functional assessment of stenosis hemodynamic significance directly influenced the treatment tactics.

Conclusion. The registry data indicate the significant role of functional methods among intravascular diagnostic options in the practice of domestic clinics participating in the registry. The registry demonstrated their use as a primary diagnosis 2 times more often than for coronary artery stenting. Some indications for the active use of intravascular physiology methods (in acute coronary syndrome, left coronary artery involvement) are currently controversial and require further research.

About the Authors

V. V. Demin
Orenburg Regional Clinical Hospital; Orenburg State Medical University
Russian Federation

Orenburg



A. M. Babunashvili
Center for Endosurgery and Lithotripsy; I. M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



T. V. Kislukhin
Polyakov Samara Regional Clinical Cardiology Dispensary
Russian Federation

Samara



E. Yu. Kostyrin
Polyakov Samara Regional Clinical Cardiology Dispensary
Russian Federation

Samara



Z. Kh. Shugushev
Central Clinical Hospital "Russian Railways-Medicine"
Russian Federation

Moscow



V. N. Ardeev
Vsevolozhsk Clinical Interdistrict Hospital
Russian Federation

Vsevolozhsk



E. V. Merkulov
Chazov National Medical Research Center of Cardiology
Russian Federation

Moscow



Yu. G. Matchin
Chazov National Medical Research Center of Cardiology
Russian Federation

Moscow



E. Yu. Gubarenko
Altai Regional Cardiology Dispensary
Russian Federation

7Altai Regional Cardiology Dispensary



N. A. Kochergin
8Research Institute for Complex Issues of Cardiovascular Diseases
Russian Federation

Kemerovo



S. P. Semitko
I. M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



A. A. Anufriev
MEDASSIST Medical Center
Russian Federation

Kursk



A. V. Ter-Akopyan
Central Clinical Hospital with a Polyclinic of the Administrative Directorate of the President of the Russian Federation
Russian Federation

Moscow



D. V. Teplyakov
City Pokrovskaya Hospital,
Russian Federation

St. Petersburg



O. E. Zauralov
Vsevolozhsk Clinical Interdistrict Hospital
Russian Federation

Vsevolozhsk



G. K Arutyunyan
Chazov National Medical Research Center of Cardiology
Russian Federation

Moscow



R. F. Atanesyan
Chazov National Medical Research Center of Cardiology
Russian Federation

Moscow



D. A. Asadov
I. M. Sechenov First Moscow State Medical University
Russian Federation

Moscow



V. A. Ignatov
Chelyabinsk Regional Clinical Hospital
Russian Federation

Chelyabinsk



A. V. Azarov
Vladimirsky Moscow Regional Research Clinical Institute
Russian Federation

Moscow



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Supplementary files

  • In 2021, the first Russian registry on the use of intra­vascular imaging and physiology methods was created.
  • Routine use of intravascular physiology allows for more differentiated indications for percutaneous coronary intervention.
  • Targeted revascularization of hemodynamically significant coronary artery lesions leads to reduction of angina and improved clinical outcomes.
  • The Russian Registry on the Use of Intravascular Imaging and Physiology data confirm the increasing importance of non-hyperemic indexes (instanta­neous wave-free ratio) and their predominance in clinical practice over the classical definition of fractional flow reserve.

Review

For citations:


Demin V.V., Babunashvili A.M., Kislukhin T.V., Kostyrin E.Yu., Shugushev Z.Kh., Ardeev V.N., Merkulov E.V., Matchin Yu.G., Gubarenko E.Yu., Kochergin N.A., Semitko S.P., Anufriev A.A., Ter-Akopyan A.V., Teplyakov D.V., Zauralov O.E., Arutyunyan G.K., Atanesyan R.F., Asadov D.A., Ignatov V.A., Azarov A.V. Application of intravascular physiology methods in clinical practice: two-year data from the Russian registry. Russian Journal of Cardiology. 2024;29(2):5622. (In Russ.) https://doi.org/10.15829/1560-4071-2024-5622. EDN: YUWLSY

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ISSN 1560-4071 (Print)
ISSN 2618-7620 (Online)