Additive Value of Physiology Coronary in Clinical Practice

Study Overview
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Brief Summary
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The important evidence of coronary microcirculation for the management of patients with coronary artery disease is only increasing. Thus, in recent years, a number of studies have shown that the demonstration of coronary microvascular disease (CMVD) contributes to cardiovascular morbidity and mortality increases independently of epicardial damage. This has been shown in stable coronary artery disease with screening for CMVD when there is no significant epicardial involvement and allowing the implementation of an adapted treatment then reducing the symptoms and improving the quality of life of our patients. (1). The prognostic nature of CMVD has also been identified in stable disease after coronary angioplasty (2) but also in patients with infarcts reperfused by coronary angioplasty (3). The complete exploration of the epicardial and microvascular coronary vascularization is grouped under the name of the subspecialty: coronary physiology. Thus, an internationally recognized algorithm for exploring coronary physiology has been published (4). However, this algorithm is still little followed. The PRINCIPE registry aims to assess the prevalence of CMVD with the use of a standardized algorithm for exploring coronary physiology by coronary angiography in our center in current practice.

Official Title
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Additive Value of Physiology Coronary in Clinical Practice

Conditions
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Microvascular Coronary Artery Disease

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Male or female patients over 18 years of age Having a coronary angiography Presenting in pain or having performed a positive ischemia test Affiliated with social security Non-opposition to participation Exclusion Criteria: Adult patient protected by law (article L1121-8) Person deprived of liberty (article L1121-8) Pregnant woman

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of CMVD defined by microcirculatory resistance index (IMR) > 25 |  | At inclusion | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Prevalence of macro and microvascular angina | Macro and microvascular angina rate according to international angiographic diagnostic criteria | At inclusion | 
| Correlation between coronary physiology parameters and imaging data | Coronary angiography and coronary physiology parameters:% of epicardial stenosis, FFR, CFR, IMR | At inclusion | 
| Correlation between coronary physiology parameters and imaging data | SPEC parameters | At inclusion | 
| Correlation between coronary physiology parameters and imaging data | Cardiac echography parameters | At inclusion | 
| Correlation between coronary physiology parameters and imaging data | Stress cardiac echography parameters | At inclusion | 
| Correlation between coronary physiology parameters and imaging data | MRI parameters | At inclusion | 
| Correlation between coronary physiology parameters and imaging data | Cardiac CT parameters | At inclusion | 
| Assessment of the symptoms of angina pectoris | Brief angina questionnaire | 12 months | 
| Compare the rate of peri-procedural myocardial distress | Post PCI troponin rate | At inclusion | 
| Evaluate medical consumption | Number of medical consultation | 12 months | 
| Evaluation of serious cardiovascular event rate | Cardiovascular event | 12 months |