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Persistent or Recurrent Angina Following Percutaneous Coronary Revascularization

Muhammad Ajmal1,2, Arka Chatterjee1, Deepak Acharya3

  • 1Division of Cardiovascular Diseases, University of Arizona, 1625 N Campbell Avenue, Tucson, AZ, 85719, USA.

Current Cardiology Reports
|October 26, 2022
PubMed

Insights

Persistent angina after percutaneous coronary intervention (PCI) can be effectively managed. New diagnostic tools and phenotype-guided therapies, including functional testing and addressing coronary vasomotor disorders, improve patient outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology

Background:

  • Persistent or recurrent angina post-percutaneous coronary intervention (PCI) significantly impacts patient well-being and healthcare costs.
  • Evolving understanding of post-PCI angina pathophysiology necessitates updated diagnostic and therapeutic strategies.

Purpose of the Study:

  • To provide a comprehensive review of the mechanisms, diagnostic approaches, and treatment options for angina following PCI.
  • To highlight advancements in functional testing and phenotype-guided therapies for post-PCI angina.

Main Methods:

  • Review of current literature on post-PCI angina.
  • Analysis of diagnostic strategies including noninvasive and invasive techniques.
  • Evaluation of therapeutic options, encompassing pharmacologic and nonpharmacologic modalities.

Main Results:

  • Functional testing during PCI may lead to more accurate revascularization.
  • Coronary vasomotor disorders are a common cause of angina post-PCI, even without obstructive coronary artery disease.
  • Invasive coronary vasoreactivity testing facilitates phenotype-guided treatment for coronary vasomotor disorders, improving angina symptoms.

Conclusions:

  • A thorough diagnostic approach combining noninvasive and invasive methods is crucial for persistent or recurrent angina after PCI.
  • Individualized, phenotype-guided management strategies incorporating lifestyle, pharmacologic, and nonpharmacologic treatments are essential for optimizing patient outcomes.
  • Ongoing development of nonpharmacologic treatments offers future therapeutic avenues for refractory angina.
Abstract

Keywords:
Angina pectorisMicrovascular dysfunctionPercutaneous coronary interventionRefractory angina

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