The Year in Cardiology

Coronary Interventions: The Year in Cardiology 2019

Andreas Baumbach; Christos V. Bourantas; PatrickW. Serruys; William Wijns


Eur Heart J. 2020;41(3):394-405. 

In This Article


Published research in 2019 examining the efficacy of different treatment strategies, of emerging or existing devices and of the value of coronary physiology or intravascular imaging in PCI planning has enriched our understanding and modified the treatment of patients with obstructive CAD (Take home figure). Patients suffering from a STEMI should be treated aggressively aiming for complete revascularization. Conversely, an initially conservative management in patients with an out of hospital cardiac arrest without clinical evidence of ongoing acute ischaemia seems to be equally effective as an early invasive approach. Robust evidence highlights the short- and long-term efficacy of DES, while advances in coronary physiology and the development of image-based methodologies for the computation of FFR are expected to broaden its use in guiding revascularization. Cumulative data underscore the prognostic benefit of intravascular imaging in guiding PCI and in assessing lesion pathology, while advances in intravascular imaging and computational modelling are anticipated to allow better prediction of vulnerable lesions and of patients at risk that will benefit from emerging therapies targeting plaque evolution. These developments are expected to improve procedural results and long-term outcomes in patients with CAD through personalized pharmaco-invasive strategies.

Take home figure.

Summary of the important clinical studies published in the field in 2019 that will have an impact on the clinical practice. AF, atrial fibrillation; BRS, bioresorbable scaffold; CTO, chronic total occlusion; DES, drug-eluting stent; ISR, in stent restenosis; IVUS, intravascular ultrasound; OFR, optical coherence tomography-based fractional flow reserve software; STEMI, ST elevation myocardial infarction; vFFR, vessel fractional flow reserve software.