Evidence mapPaperPMID 41716720Full record

ArticleInternational journal of cardiology. Heart & vasculature2026

The impact of pullback measurement on treatment decision in significant coronary artery disease: Insights from a retrospective multicentric study.

Roberto Bova, Matteo Betti, Samuel Heuts, Pieter A Vriesendorp, Alexander J J Ijsselmuiden, Saman Rasoul, Mustafa Ilhan, Jindra Vainer, Ralph A L J Theunissen, Leo F Veenstra and 6 more

Abstract read
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Article in International journal of cardiology. Heart & vasculature, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

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No citing paper in PubMed yet.

4 · The record

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PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Roberto BovaDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Matteo BettiDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Samuel HeutsCardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Pieter A VriesendorpDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Alexander J J IjsselmuidenDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Saman RasoulDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Mustafa IlhanDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Jindra VainerDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Ralph A L J TheunissenDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Leo F VeenstraDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Patty WinklerCardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Mera SteinCardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Alexander RuitersCardiovascular Research Institute Maastricht, Maastricht, The Netherlands.
Daniek P J SlegersDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Arnoud W J van 't HofDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.
Arpad LuxDepartment of Cardiology, Maastricht University Medical Centre+, Maastricht, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Optimal management of coronary artery disease (CAD) requires tailoring treatment strategies to lesion characteristics. Intracoronary pullback enables hemodynamic mapping of coronary lesions, potentially improving therapeutic decision-making, particularly in distinguishing focal from diffuse disease. Objectives: To evaluate how pullback measurement influences overall treatment strategy-optimal medical therapy (OMT), percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG)-in patients with significant CAD. Methods: We conducted a retrospective, multicenter cohort study including 842 patients with stable angina, unstable angina, or non-ST-elevation myocardial infarction (NSTEMI) and functionally significant left anterior descending artery (LAD) disease. Patients were stratified into two groups: one group (PB group, n = 561) had pullback measurement, and the other (Conventional group, n = 281) not. Outcomes included treatment strategy, major adverse cardiovascular events (MACE), and all-cause mortality at 1 year. Results: Pullback led to more Heart Team discussions (66.3% vs. 58.7%; p = 0.033), greater adoption of OMT (51.5% vs. 40.9%; p = 0.004), and lower PCI rates (27.1% vs. 36.3%; p = 0.007). CABG rates remained unaffected. Pullback independently increased the odds of OMT and reduced the odds of PCI (OR = 0.58, p = 0.003), while three-vessel disease strongly predicted CABG (OR = 2.51; p < 0.001). At 1 year, the PB group had higher mortality (4.3% vs. 1.1%, p = 0.013), but similar MACE compared to the Conventional group. However, clinical outcomes did not differ between treatment groups. Conclusions: Intracoronary pullback favours a conservative treatment strategy. MACE rates are not increased at 1 year.

Indexed as

Coronary physiologyOptimal medical therapyPullbackRevascularization

Identifiers

PMID41716720
PMCPMC12914282

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.