Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy.
Department of Cardiovascular and Thoracic Sciences, Catholic University of the Sacred Heart, Rome, Italy; Interventional Cardiology, IRCCS Policlinico San Donato, Milan, Italy.
Int J Cardiol. 2017 Dec 1;248:14-19. doi: 10.1016/j.ijcard.2017.07.105. Epub 2017 Aug 12.
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.
经皮冠状动脉介入治疗（PCI）成功后心绞痛的持续或复发是一个重要的临床问题，涉及到五分之一至三分之一的患者在一年的随访中进行了心肌血运重建。强烈需要对这种综合征进行系统的处理。精准医学在解决 PCI 后心绞痛方面尤为重要，因为其有多种潜在的病因。在一些患者中，成功 PCI 后症状复发的原因是再狭窄或冠状动脉粥样硬化进展，而在其余患者中，功能原因，包括心外膜冠状动脉的血管舒缩异常和/或冠状动脉微血管功能障碍，解释了症状的发生。在这篇综述中，我们总结了 PCI 后持续性或复发性心绞痛的机制，并提出了一个诊断算法和一个系统的治疗方法。
