Hak Seung LeeJoo Myung LeeChang Wook NamEun Seok ShinJoon Hyung DohNeng DaiMartin K.C. NgAndy S.C. YongDamras TresukosolAjit S. MullasariRony MathewPraveen ChandraKuang Te WangYundai ChenJiyan ChenKai Hang YiuNils P. JohnsonBon Kwon KooKeimyung University, Dongsan Medical CenterGeneral Hospital of People's Liberation ArmyGuangdong General HospitalConcord Repatriation General HospitalMackay Memorial Hospital TaiwanUniversity of Texas Medical School at HoustonSeoul National University HospitalRoyal Prince Alfred HospitalSungKyunKwan University, School of MedicineInje UniversityFaculty of Medicine, Siriraj Hospital, Mahidol UniversityFudan UniversityThe University of Hong KongUniversity of Ulsan, College of MedicineInstitute of Cardiovascular Diseases IndiaMedantaLisie Hospital2020-01-272020-01-272019-06-01Cardiology Journal. Vol.26, No.3 (2019), 215-2251898018X189755932-s2.0-85068886195https://repository.li.mahidol.ac.th/handle/20.500.14594/51637© 2019 Via Medica. Background: Currently, invasive physiologic assessment such as fractional flow reserve is widely used worldwide with different adoption rates around the globe. Patient characteristics and physician preferences often differ in the Asia-Pacific (APAC) region with respect to treatment strategy, techniques, lesion complexity, access to coronary physiology and imaging devices, as well as patient management. Thus, there is a need to construct a consensus document on recommendations for use of physiology-guided percutaneous coronary intervention (PCI) in APAC populations. This document serves as an overview of recommendations describing the best practices for APAC populations to achieve more consistent and optimal clinical outcomes. Methods and Results: A comprehensive multiple-choice questionnaire was provided to 20 interventional cardiologists from 10 countries in the APAC region. Clinical evidence, tips and techniques, and clinical situations for the use of physiology-guided PCI in APAC were reviewed and used to propose key recommendations. There are suggestions to continue to develop evidence for lesion and patient types that will benefit from physiology, develop directions for future research in health economics and local data, develop appropriate use criteria in different countries, and emphasize the importance of education of all stakeholders. A consensus recommendation to enhance the penetration of invasive physiology-based therapy was to adopt the 5E approach: Evidence, Education, Expand hardware, Economics and Expert consensus. Conclusions: This consensus document and recommendations support interventional fellows and cardiologists, hospital administrators, patients, and medical device companies to build confidence and encourage wider implementation of invasive coronary physiology-guided therapy in the APAC region.Mahidol UniversityMedicineArticleSCOPUS10.5603/CJ.a2019.0054