Journal
INTERNATIONAL JOURNAL OF CARDIOLOGY
Volume 248, Issue -, Pages 14-19Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.ijcard.2017.07.105
Keywords
Angina; Percutaneous coronary intervention; Microvascular dysfunction
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Persistence or recurrence of angina after successful percutaneous coronary intervention (PCI) represent an important clinical issue involving from one fifth to one third of patients undergoing myocardial revascularization at one-year follow-up. A systematic approach to this syndrome is strongly needed. Precision medicine is particularly important in addressing angina after successful PCI because of the multiple underlying causes. Restenosis or coronary atherosclerosis progression explain symptom recurrence after successful PCI in some patients, while functional causes, including vasomotor abnormalities of epicardial coronary arteries and/or coronary microvascular dysfunction, explain symptoms in the remaining patients. In this review, we summarize the mechanisms of persistent or recurrent angina after PCI, proposing a diagnostic algorithm and a systematic therapeutic approach. (C) 2017 Elsevier B.V. All rights reserved.
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