Comprehensive Invasive Physiological Evaluation of Obstructive Coronary Artery Disease

Inclusive Invasive Physiological Assessment in Angina Syndromes - Obstructive Coronary Artery Disease

The goal of this clinical trial is to test whether adding coronary function testing and starting targeted medical treatment for identified vasomotor disorders will also improve angina symptoms and quality of life in patients with obstructive coronary artery disease who undergo percutaneous coronary intervention. The main question it aims to answer is:

Does performing coronary function testing in patients with obstructive coronary artery disease who undergo percutaneous coronary intervention lead to better relieve of angina symptoms and improvement in quality of life?

Researchers will compare this group undergoing coronary function testing with a control group who will solely undergo percutaneous coronary intervention.

Participants will:

• Undergo percutaneous coronary intervention and coronary function testing in the intervention arm
• Undergo percutaneous coronary intervention in the control arm

Inclusion Criteria:

• Patients >18 years of age
• Hemodynamically relevant obstructive coronary artery disease (as assessed by pressure wire evaluation) in the left anterior descending coronary artery amenable to percutaneous coronary intervention at the discretion of the operator.

Exclusion Criteria:

• Prior coronary artery bypass graft surgery.
• Stenosis >90% in the target vessel or a stenosis deemed unsafe for pressure wire instrumentation
• Known severe left ventricular dysfunction (left ventricular ejection fraction by any imaging modality)
• Severe valvular disease
• Renal impairment (estimated glomerular filtration rate <30mL/min)
• Contra-indications for the use of adenosine or acetylcholine
• Expected inability to conform to the clinical follow-up
• Unable or unwilling to use the ORBITA-app
• Life expectancy of less than 12 months.