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

doi:10.1093/eurheartj/ehy857

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

MED - Medical Sciences

Research output: Contribution to journal › Review article › peer-review

60 Citations (Scopus)

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 language	English
Pages (from-to)	2455-2462
Number of pages	8
Journal	European Heart Journal
Volume	40
Issue number	29
DOIs	https://doi.org/10.1093/eurheartj/ehy857
Publication status	Published - 2019 Aug

Keywords

Coronary microvascular dysfunction
Coronary spasm
Coronary stenosis
Percutaneous coronary intervention
Stable angina

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1093/eurheartj/ehy857

Cite this

@article{2d24ac92e0bb42d389479d9ce93b06be,

title = "Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization",

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.",

keywords = "Coronary microvascular dysfunction, Coronary spasm, Coronary stenosis, Percutaneous coronary intervention, Stable angina",

author = "Filippo Crea and {Bairey Merz}, {Cathleen Noel} and Beltrame, {John F.} and Colin Berry and Camici, {Paolo G.} and Kaski, {Juan Carlos} and Peter Ong and Pepine, {Carl J.} and Udo Sechtem and Hiroaki Shimokawa",

note = "Funding Information: Conflict of interest: F.C. reports speaker fees from AstraZeneca, Amgen and Servier and institutional agreements between his employer, the Catholic University, and Biotronik, Boheringer Ingelheim. C.N.B.M. reports lecturer fees from Abbott Diagnostics and Board Director fees from iRhythm. C.B. declares institutional agreements between his employer, the University of Glasgow, and Abbott Vascular, AstraZeneca, Boehringer Ingelheim, Coroventis, DalCor, GSK, HeartFlow, Novartis, and Philips. P.G.C. reports personal consultant fees from Servier. P.O. reports personal fees from Menarini Berlin Chemie and grants from Sanofi. None of the declared interests regard the submitted work. All other authors have nothing to disclose. Publisher Copyright: {\textcopyright} The Author(s) 2019.",

year = "2019",

month = aug,

doi = "10.1093/eurheartj/ehy857",

language = "English",

volume = "40",

pages = "2455--2462",

journal = "European Heart Journal",

issn = "0195-668X",

publisher = "Oxford University Press",

number = "29",

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TY - JOUR

T1 - Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization

AU - Crea, Filippo

AU - Bairey Merz, Cathleen Noel

AU - Beltrame, John F.

AU - Berry, Colin

AU - Camici, Paolo G.

AU - Kaski, Juan Carlos

AU - Ong, Peter

AU - Pepine, Carl J.

AU - Sechtem, Udo

AU - Shimokawa, Hiroaki

N1 - Funding Information: Conflict of interest: F.C. reports speaker fees from AstraZeneca, Amgen and Servier and institutional agreements between his employer, the Catholic University, and Biotronik, Boheringer Ingelheim. C.N.B.M. reports lecturer fees from Abbott Diagnostics and Board Director fees from iRhythm. C.B. declares institutional agreements between his employer, the University of Glasgow, and Abbott Vascular, AstraZeneca, Boehringer Ingelheim, Coroventis, DalCor, GSK, HeartFlow, Novartis, and Philips. P.G.C. reports personal consultant fees from Servier. P.O. reports personal fees from Menarini Berlin Chemie and grants from Sanofi. None of the declared interests regard the submitted work. All other authors have nothing to disclose. Publisher Copyright: © The Author(s) 2019.

PY - 2019/8

Y1 - 2019/8

N2 - 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.

AB - 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.

KW - Coronary microvascular dysfunction

KW - Coronary spasm

KW - Coronary stenosis

KW - Percutaneous coronary intervention

KW - Stable angina

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U2 - 10.1093/eurheartj/ehy857

DO - 10.1093/eurheartj/ehy857

M3 - Review article

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SN - 0195-668X

VL - 40

SP - 2455

EP - 2462

JO - European Heart Journal

JF - European Heart Journal

IS - 29

ER -

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

Abstract

Keywords

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