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Management of Angina Post Percutaneous Coronary Intervention

Jose B Cruz Rodriguez1, Subrata Kar2

  • 1Division of Cardiovascular Medicine, Texas Tech University Health Sciences Center, El Paso, TX, USA.

Current Cardiology Reports
|January 23, 2020
PubMed

Insights

Post percutaneous coronary intervention angina (PPCIA) affects many patients. Management strategies vary, and optimal treatment for PPCIA requires further research and individualized patient care.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Post percutaneous coronary intervention angina (PPCIA) affects 20-40% of patients.
  • PPCIA imposes a significant burden on healthcare systems.

Purpose of the Study:

  • To review the management of post percutaneous coronary intervention angina (PPCIA).
  • To discuss the mechanisms and current treatment options for PPCIA.

Main Methods:

  • Review of current literature on PPCIA management.
  • Discussion of diagnostic tools including stress echocardiography, cardiac magnetic resonance, vasoprovocative testing, and fractional flow reserve.
  • Analysis of medical management options such as nitrates, beta blockers (BB), calcium channel blockers, and ranolazine.

Main Results:

  • PPCIA mechanisms include microvascular dysfunction, vasospasm, microembolization, myocardial bridge, CAD progression, stent thrombosis, and in-stent restenosis.
  • Beta blockers (BB) demonstrated a 1-year mortality benefit post-myocardial infarction.
  • Diagnostic modalities like stress echocardiography and cardiac MRI are effective for detecting CAD and microvascular dysfunction.

Conclusions:

  • Optimal management of PPCIA is not yet clearly defined.
  • Further research is necessary to establish definitive treatment guidelines.
  • Treatment should be individualized based on patient-specific factors and ischemia burden.
Abstract

Keywords:
AnginaPercutaneous coronary interventionStable coronary artery disease

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