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. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2019. For permissions, please email: firstname.lastname@example.org.
Crea, F., Bairey Merz, CN., Beltrame, JF., Berry, C., Camici, PG., Kaski, JC., Ong, P., Pepine, CJ., Sechtem, U., Shimokawa, H., & (COVADIS), O. B. O. T. C. V. D. I. S. G. (2019). Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization: European heart journal. European Heart Journal, 40(29), 2455-2462. https://doi.org/10.1093/eurheartj/ehy857