{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T21:36:25Z","timestamp":1773783385178,"version":"3.50.1"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Cardiovascular Interventions"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>Current clinical guidelines recommend considering both obstructive and nonobstructive causes of myocardial ischemia in patients with chronic coronary syndrome. Wire-based physiological assessment constitutes a valid approach for this purpose, but it remains underutilized. We evaluated the diagnostic yield and clinical impact of an alternative wire-free approach for this purpose.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>This is a subanalysis of the multicenter, prospective AID-ANGIO study (Advanced Invasive Diagnosis for Patients with Chronic Coronary Syndromes Undergoing Coronary Angiography), evaluating the impact of a wire-free advanced invasive diagnosis (AID) strategy in the diagnostic workflow of patients with chronic coronary syndrome admitted to the catheterization laboratory. The wire-free AID strategy combined quantitative flow ratio for epicardial evaluation, contrast angiography-derived index of coronary microcirculatory resistance for microvascular assessment, and acetylcholine testing for the endothelial-dependent coronary function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      The study included 262 patients. The wire-free AID strategy identified a cause of myocardial ischemia in 84.3% of patients, representing a 2-fold increase in the identification of a cause of myocardial ischemia, compared with coronary angiography alone (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt;0.0001). In addition, the wire-free AID strategy demonstrated substantial agreement compared with the wire-based AID strategy (Cohen \u03ba 0.78). The wire-free AID strategy led to a change in the initial therapeutic plan in 55.3% of patients compared with coronary angiography. Nevertheless, the wire-free AID strategy maintained good concordance with the wire-based AID strategy (16.8% of therapeutic changes).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>This study supports the clinical utility of a wire-free AID strategy in patients with chronic coronary syndrome, demonstrating its potential to improve diagnostic yield and guide clinical decision-making compared with coronary angiography alone. In addition, it shows substantial agreement with the wire-based approach.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/circinterventions.125.016088","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T10:00:15Z","timestamp":1769767215000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Comprehensive Diagnosis of Myocardial Ischemia of Obstructive and Nonobstructive Origin With a Wire-Free Diagnostic Strategy"],"prefix":"10.1161","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4045-2859","authenticated-orcid":true,"given":"Marco","family":"Lombardi","sequence":"first","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Spain (M.L., A.J., A.L., L.P., G.N., J.C.D.-P., A.T., P.J.-Q., F.M.-T., G.T.C., L.N.-F., P.S., A.I.F.-O., H.M.-R., N.G., J.E.)."},{"name":"Department of Internal Medicine, University of Genova, Italy (M.L.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4645-2702","authenticated-orcid":true,"given":"Adrian","family":"Jeronimo","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Spain (M.L., A.J., A.L., L.P., G.N., J.C.D.-P., A.T., P.J.-Q., F.M.-T., G.T.C., L.N.-F., P.S., A.I.F.-O., H.M.-R., N.G., J.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akram","family":"Lahrifa","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Spain (M.L., A.J., A.L., L.P., G.N., J.C.D.-P., A.T., P.J.-Q., F.M.-T., G.T.C., L.N.-F., P.S., A.I.F.-O., H.M.-R., N.G., J.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luca","family":"Paolucci","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Spain (M.L., A.J., A.L., L.P., G.N., J.C.D.-P., A.T., P.J.-Q., F.M.-T., G.T.C., L.N.-F., P.S., A.I.F.-O., H.M.-R., N.G., J.E.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8144-0117","authenticated-orcid":true,"given":"Giulia","family":"Nardi","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Spain (M.L., A.J., A.L., L.P., G.N., J.C.D.-P., A.T., P.J.-Q., F.M.-T., G.T.C., L.N.-F., P.S., A.I.F.-O., H.M.-R., N.G., J.E.)."},{"name":"Structural Interventional Cardiology, Careggi University Hospital, Florence, Italy (G.N.)."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juan Carlos","family":"Diaz-Polanco","sequence":"additional","affiliation":[{"name":"Hospital Cl\u00ednico San Carlos, IdISSC, and CIBERCV, Complutense University of Madrid, Spain (M.L., A.J., A.L., L.P., G.N., 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