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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
Summary
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.
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