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

被引:141
作者
Crea, Filippo [1 ]
Merz, Cathleen Noel Bairey [2 ]
Beltrame, John F. [3 ]
Berry, Colin [4 ]
Camici, Paolo G. [5 ,6 ]
Kaski, Juan Carlos [7 ]
Ong, Peter [8 ]
Pepine, Carl J. [9 ]
Sechtem, Udo [8 ]
Shimokawa, Hiroaki [10 ]
机构
[1] Univ Cattolica Sacro Cuore, Fdn Policlin Gemelli IRCCS, Dept Cardiovasc & Thorac Sci, Largo F Vito 1, I-00168 Rome, Italy
[2] Cedars Sinai Med Ctr, Smidt Cedars Sinai Heart Inst, Barbra Streisand Womens Heart Ctr, 127 San Vicente Blvd, Los Angeles, CA 90048 USA
[3] Queen Elizabeth Hosp, Discipline Med, Ward 5B,28 Woodville Rd, Adelaide, SA 5011, Australia
[4] Univ Glasgow, British Heart Fdn, Glasgow Cardiovasc Res Ctr, Inst Cardiovasc & Med Sci, Univ Pl, Glasgow G12 8TA, Lanark, Scotland
[5] Univ Vita Salute San Raffaele, Dept Cardiol, Via Olgettina 60, I-20132 Milan, Italy
[6] Osped San Raffaele, Via Olgettina 60, I-20132 Milan, Italy
[7] St Georges Univ London, Mol & Clin Sci Res Inst, Cranmer Terrace, London SW17 0RE, England
[8] Robert Bosch Krankenhaus, Dept Cardiol, Auerbachstr 10, D-70376 Stuttgart, Germany
[9] Univ Florida, Dept Med, Div Cardiovasc Med, Coll Med, 1600 SW Archer Rd,Box 100288, Gainesville, FL 32610 USA
[10] Tohoku Univ, Grad Sch Med, Dept Cardiovasc Med, Aoba Ku, Seiryo Machi, Sendai, Miyagi 9808574, Japan
关键词
Coronary microvascular dysfunction; Coronary spasm; Coronary stenosis; Percutaneous coronary intervention; Stable angina; MICROVASCULAR DYSFUNCTION; ELUTING STENT; ARTERY-DISEASE; INTERNATIONAL STANDARDIZATION; HYPERCONSTRICTING RESPONSES; INTRACORONARY ACETYLCHOLINE; VASOMOTION ABNORMALITIES; PROGNOSTIC VALUE; MEDICAL THERAPY; STABLE ANGINA;
D O I
10.1093/eurheartj/ehy857
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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.
引用
收藏
页码:2455 / +
页数:10
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