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Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary
Filippo Crea1, Cathleen Noel Bairey Merz2, John F Beltrame3
1Department of Cardiovascular and Thoracic Sciences, Fondazione Policlinico Gemelli - IRCCS, Università Cattolica del Sacro Cuore, Largo F. Vito 1, Roma, Italy.
European Heart Journal
|January 5, 2019
Summary
Persistent angina after percutaneous coronary intervention (PCI) affects many patients, increasing healthcare costs. This review explores post-PCI angina mechanisms and proposes diagnostic strategies.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Persistent or recurrent angina affects 20-40% of patients post-percutaneous coronary intervention (PCI), even with optimized techniques.
- This condition significantly increases healthcare costs, nearly doubling them compared to symptom-free patients.
- Current practice guidelines offer limited clarity on managing post-PCI angina.
Purpose of the Study:
- To review potential mechanisms underlying persistent or recurrent angina after PCI.
- To propose a practical diagnostic algorithm for post-PCI angina.
- To summarize existing knowledge gaps and highlight areas for future research.
Main Methods:
- Literature review of studies on post-PCI angina.
- Analysis of potential etiological factors.
- Development of a diagnostic pathway.
Main Results:
- Identified multiple potential mechanisms for angina persistence post-PCI.
- Proposed a structured approach for diagnosing the cause of ongoing chest pain.
- Highlighted the need for further research into specific pathophysiological pathways.
Conclusions:
- Understanding the mechanisms of post-PCI angina is crucial for effective patient management.
- A systematic diagnostic approach can aid in identifying the cause of persistent symptoms.
- Further research is warranted to address current evidence gaps and refine treatment strategies.
Keywords:
Coronary microvascular dysfunctionCoronary spasmCoronary stenosisPercutaneous coronary interventionStable anginaMore Related Videos
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