Heart attack prevention showdown: plaque scans vs. blood flow tests

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: ① Patients aged 19 years or older ② Patients with moderate to severe coronary artery stenosis identified on coronary angiography: A. Diameter stenosis of 50%-90% by visual estimation B. De novo lesions (newly developed lesions) C. Reference vessel diameter ≥ 2.5 mm by visual estimation ③ Patients with either clinically high-risk features for recurrent ischemic events or complex high-risk lesions identified on angiography: A. Clinically high-risk features i. Medically treated diabetes mellitus ii. Chronic kidney disease (≥ Stage 3B, eGFR \< 45 mL/min/1.73 m²) iii. Acute coronary syndrome (ACS) iv. Previous myocardial infarction (MI) B. Complex high-risk lesions i. True bifurcation lesions ii. Calcified lesions (moderate to severe calcification on angiography) iii. Diffuse long lesions (≥ 30 mm in length) iv. Multivessel disease v. Multiple lesions (≥ 3 lesions) ④ Patients who can verbally demonstrate an understanding of the risks, benefits, and alternative treatments of invasive physiologic or imaging assessment and PCI ⑤ Patients who agree to the study protocol and clinical follow-up plan, voluntarily decide to participate, and provide written informed consent to participate in this clinical trial Exclusion Criteria: * Hypersensitivity or contraindication to any of the following medications: heparin, aspirin, clopidogrel, prasugrel, ticagrelor, adenosine, or nicorandil * Hemodynamic instability requiring mechanical circulatory support (ECMO or IABP) * Moderate or severe stenosis of the left main coronary artery (diameter stenosis \> 50%) * History of coronary artery bypass grafting (CABG) * Severe asthma or severe chronic obstructive pulmonary disease (COPD) ⑥ Active bleeding ⑦ Major gastrointestinal or genitourinary bleeding within the previous 3 months ⑧ Bleeding diathesis or known coagulopathy, including a history of heparin-induced thrombocytopenia (HIT) ⑨ Life expectancy \< 2 years due to non-cardiovascular comorbidities ⑩ Inability to provide signed informed consent ⑪ Any condition deemed by the investigator to make the patient unsuitable for this clinical trial or likely to increase study-related risks