Cardiovascular disease is rapidly becoming one of the biggest health concerns globally, including in the country, accounting for nearly 31 per cent of all deaths in India.
What worries us even more as cardiologists is that Indians are developing heart disease almost 8–10 years earlier than people in Western countries.
Over the years, we have seen a growing number of younger patients arriving with serious cardiac conditions, making early diagnosis and advanced treatment more important than ever. While percutaneous coronary intervention (PCI), commonly known as angioplasty with stenting, has remained one of the most effective treatments for blocked coronary arteries, modern cardiology is now moving towards a far more refined and patient-specific approach, known as precision PCI.
Traditionally, PCI procedures were guided mainly through coronary angiography, which provides a two-dimensional image of the artery.
However, in my experience, angiography alone has several limitations. It often cannot clearly reveal plaque characteristics, calcium burden, or whether a blockage is truly restricting blood flow to the heart muscle. Precision PCI helps us bridge this gap by using next-generation technologies that allow more accurate diagnosis, and treatment planning. One of the most important advancements has been the introduction of intravascular imaging technologies such as intravascular ultrasound (IVUS) and optical coherence tomography (OCT).
These enable us to look inside the artery and assess plaque composition, vessel size, calcium distribution, and stent placement with remarkable precision.
IVUS and OCT are especially useful during complex procedures, as they help us identify issues in real time and make necessary adjustments immediately. Studies have shown that imaging-guided PCI improves procedural success, and reduces complications. Another major advancement is the use of fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR), which help determine whether a blockage is actually affecting blood supply to the heart. This allows us to avoid unnecessary stenting, and provide more targeted treatment to patients.
The newer generation drug-eluting stents, designed with thinner struts and improved flexibility, have also significantly improved long-term outcomes. At the same time, artificial intelligence (AI) is beginning to transform interventional cardiology by assisting physicians in identifying risks and optimising strategies. However, I strongly believe that even the most advanced procedures cannot replace a healthy lifestyle.
Managing heart disease requires long-term commitment through proper diet, regular exercise, stress management and routine medical follow-up. Precision PCI is a major leap forward, but lasting heart health ultimately depends on how well patients take care of themselves after treatment.
— As told to Amritsar Tribune’s Manmeet Singh Gill
