Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization

Filippo Crea, Cathleen Noel Bairey Merz, John F Beltrame, Colin Berry, Paolo G Camici, Juan Carlos Kaski, Peter Ong, Carl J Pepine, Udo Sechtem, Hiroaki Shimokawa

Research output: Contribution to journalArticle

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.

Original languageEnglish
Pages (from-to)2455-2462
Number of pages8
JournalEuropean Heart Journal
Volume40
Issue number29
DOIs
Publication statusPublished - Aug 1 2019

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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. (2019). Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization. European Heart Journal, 40(29), 2455-2462. https://doi.org/10.1093/eurheartj/ehy857