Precise Percutaneous Coronary Intervention Plan (P3) Study

Multicenter study, including 120 patients at 5 centers in Europe and Asia. After identifying the presence of significant coronary stenosis by means of coronary angiography and invasive fractional flow reserve (FFR≤0.80) the patients will undergo the following procedures: Invasive FFR with intravenous adenosine (i.e. pre- and post-PCI). Optical coherence tomography-guided PCI (i.e. pre- and post-procedural imaging). PCI with newer generation drug-eluting stent.

Inclusion criteria

• Coronary artery disease in a major epicardial vessel with an invasive fractional flow reserve (FFR) ≤0.80
• An indication to Percutaneous coronary intervention

Exclusion criteria

• Angiographic exclusion criteria

• Severely calcified lesion/vessel
• Bifurcation lesions.
• Ostial lesions.
• Left main disease.
• Severe vessel tortuosity.

Clinical exclusion criteria

• Chronic obstructive pulmonary disease
• Contraindication to adenosine
• NYHA class III or IV, or last known left ventricular ejection fraction <30%
• Uncontrolled or recurrent ventricular tachycardia
• Atrial fibrillation, flutter or arrhythmia
• History of recent stroke (≤90 days)
• History of acute coronary syndrome (≤90 days)
• Prior myocardial infarction
• History of ischemic stroke (>90 days) with modified RANKIN score ≥ 2
• History of any hemorrhagic stroke
• Previous revascularization (PCI or Coronary artery bypass grafting)
• Active liver disease or hepatic dysfunction, defined as AST or ALT > 3 times the ULN
• Severe renal dysfunction, defined as an eGFR <30 mL/min/1.73 m2
• Body mass index>35 kg/m2
• Nitrate intolerance
• Contra-indication to heart rate lowering drugs

Imaging-related

• Insufficient coronary CT Angiography image quality.