Persistence or recurrence of angina after a percutaneous coronary intervention (PCI) may affect about 20-40% of patients during short-medium-term follow-up. This appears to be true even when PCI is 'optimized' using physiology-guided approaches and drug-eluting stents. Importantly, persistent or recurrent angina post-PCI is associated with a significant economic burden. Healthcare costs may be almost two-fold higher among patients with persistent or recurrent angina post-PCI vs. those who become symptom-free. However, practice guideline recommendations regarding the management of patients with angina post-PCI are unclear. Gaps in evidence into the mechanisms of post-PCI angina are relevant, and more research seems warranted. The purpose of this document is to review potential mechanisms for the persistence or recurrence of angina post-PCI, propose a practical diagnostic algorithm, and summarize current knowledge gaps.
Crea, F., Bairey Merz, C. N., Beltrame, J. F., Berry, C., Camici, P. G., Kaski, J. C., Ong, P., Pepine, C. J., Sechtem, U., Shimokawa, H., Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization, <<EUROPEAN HEART JOURNAL>>, 2019; 40 (29): 2455-2462. [doi:10.1093/eurheartj/ehy857] [http://hdl.handle.net/10807/132756]
Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization
Crea, Filippo;
2019
Abstract
Persistence or recurrence of angina after a percutaneous coronary intervention (PCI) may affect about 20-40% of patients during short-medium-term follow-up. This appears to be true even when PCI is 'optimized' using physiology-guided approaches and drug-eluting stents. Importantly, persistent or recurrent angina post-PCI is associated with a significant economic burden. Healthcare costs may be almost two-fold higher among patients with persistent or recurrent angina post-PCI vs. those who become symptom-free. However, practice guideline recommendations regarding the management of patients with angina post-PCI are unclear. Gaps in evidence into the mechanisms of post-PCI angina are relevant, and more research seems warranted. The purpose of this document is to review potential mechanisms for the persistence or recurrence of angina post-PCI, propose a practical diagnostic algorithm, and summarize current knowledge gaps.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.