Incidence and prognostic importance of silent ischaemia after PTCA: a prospective study
C Gohlke1, H Gohlke, J Petersen
1Rehabilitationszentrum für Herz- und Kreislaufkranke, Bad Krozingen, F.R.G.
European Heart Journal
|December 1, 1988
Summary
Percutaneous transluminal coronary angioplasty (PTCA) significantly reduced ischemic episodes, but silent ischemia persisted in some patients. Further research is needed to understand the causes of persistent silent ischemia post-PTCA.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Ischemic episodes, both symptomatic and silent, are key indicators of coronary artery disease.
- Percutaneous transluminal coronary angioplasty (PTCA) is a common intervention for managing coronary artery disease.
Purpose of the Study:
- To assess the impact of successful PTCA on symptomatic and asymptomatic ischemic episodes.
- To investigate the characteristics and implications of persistent or newly occurring silent ischemia after PTCA.
Main Methods:
- Prospective evaluation of 94 patients undergoing successful PTCA.
- 24-hour ambulatory electrocardiographic Holter monitoring before and after PTCA.
- Analysis of ischemic episode frequency, duration, and type (symptomatic vs. silent).
Main Results:
- Successful PTCA significantly reduced the total number and duration of ischemic episodes.
- While symptomatic episodes decreased markedly, silent ischemic episodes showed less improvement.
- Silent ischemia post-PTCA was not linked to inadequate dilatation or increased risk of restenosis.
Conclusions:
- PTCA effectively reduces overall ischemic burden but does not eliminate silent ischemia.
- Persistent silent ischemia may relate to increased vascular tone in susceptible individuals.
- Silent ischemia post-PTCA requires further investigation for underlying mechanisms and clinical significance.
Related Concept Videos
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
01:27Coronary Artery Disease V: Interprofessional Care
Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
01:30Acute Coronary Syndrome III: Diagnostic Studies
Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
01:27Angina II: Classification
Angina, also known as angina pectoris, is a chest pain resulting from diminished blood flow to the heart muscle and is often a symptom of coronary artery disease. Angina presents several variants with distinctive attributes, etiologies, and therapeutic approaches. The main types of angina include stable, unstable, variant (Prinzmetal's), microvascular, intractable, and silent ischemia.Stable angina is caused by atherosclerosis, which leads to the formation of plaques that narrow the coronary...
01:27Atherosclerosis II: Clinical Manifestations and Diagnostic Tests
Atherosclerosis is a progressive disorder that leads to the thickening and narrowing of arterial walls due to plaque buildup. This condition can cause various symptoms depending on the arteries affected:Coronary Artery Disease (CAD): This condition affects the coronary arteries and may lead to chest pain (angina), shortness of breath (dyspnea), heart attacks, and other heart disease symptoms.Cerebrovascular Disease: This affects blood flow to the brain, causing transient ischemic attacks (TIAs)...