Department of Internal Medicine, East Tennessee State University, Johnson City, TN, USA; Morehouse School of Medicine, Atlanta, GA, USA.
Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, MA, USA.
Cardiovasc Revasc Med. 2020 Dec;21(12):1517-1522. doi: 10.1016/j.carrev.2020.05.011. Epub 2020 May 16.
Early post-percutaneous coronary intervention chest pain (EPPCP) appears to be a common clinical phenomenon. EPPCP has not been fully explained or studied in the literature despite the abundance of clinical trials on percutaneous coronary intervention (PCI). The objective of this questionnaire-based survey is to assess the current perception of EPPCP among practicing interventional cardiologists nationwide.
A survey questionnaire was designed utilizing the Survey Monkey tool to address the perceptions and current practices regarding key aspects of EPPCP among interventional cardiologists. The survey was sent to the interventional cardiologists via email.
The survey questionnaire regarding EPPCP was provided to 2615 practicing interventional cardiologists and resulted in 623 total survey responses, with 503 of those respondents completing all eight survey questions. A total of 50.2% of the interventional cardiologists perceive that the incidence of EPPCP is 5-10%, and 57.5% consider that repeat angiography or PCI is rarely needed (1 in 1000 cases). A total of 47.1% of the participants think that EPPCP is due to transient microvascular dysfunction, while 39% perceive it as a different entity requiring a different approach. When asked about developing a standardized labeling for the phenomenon of EPPCP, 34.8% of responders indicated that they believe EPPCP should be labeled as a benign form of chest pain/angina, and 28% preferred to describe EPPCP in non-standardized terms. Among interventional cardiologists, 80% thought that the treatment of this entity is a combination of reassurance and vasodilators and, without ischemic ECG changes, medical management is appropriate.
A total of 72% of interventional cardiologists in our survey preferred to label EPPCP as standard nomenclature to facilitate communication between healthcare providers, patients and families in a consistent way. There is a diversity of opinion regarding EPPCP, no standard nomenclature, and no guideline to standardize practice. Further large-scale prospective studies are needed to better understand the pathophysiological mechanisms, optimal management strategies, prognostic implications, and clinical reporting of EPPCP.
经皮冠状动脉介入治疗后早期胸痛（EPPCP）似乎是一种常见的临床现象。尽管有大量关于经皮冠状动脉介入治疗（PCI）的临床试验，但 EPPCP 在文献中并未得到充分解释或研究。本问卷调查的目的是评估全国介入心脏病学家对 EPPCP 的当前认识。
利用 Survey Monkey 工具设计了调查问卷，以评估介入心脏病学家对 EPPCP 关键方面的看法和当前实践。通过电子邮件向介入心脏病学家发送了调查问卷。
向 2615 名执业介入心脏病学家提供了 EPPCP 调查问卷，共收到 623 份总调查回复，其中 503 名回答者完成了所有 8 个调查问题。50.2%的介入心脏病学家认为 EPPCP 的发生率为 5-10%，57.5%认为很少需要重复血管造影或 PCI（每 1000 例中有 1 例）。47.1%的参与者认为 EPPCP 是由于短暂的微血管功能障碍，而 39%的人认为它是一种需要不同方法的不同实体。当被问及为 EPPCP 现象制定标准化标签时，34.8%的应答者表示他们认为 EPPCP 应该被标记为良性胸痛/心绞痛形式，28%的人更喜欢用非标准化术语描述 EPPCP。在介入心脏病学家中，80%的人认为该实体的治疗方法是结合安慰和血管扩张剂，如果没有缺血性心电图改变，可采用药物治疗。
在我们的调查中，72%的介入心脏病学家更喜欢将 EPPCP 标记为标准命名法，以便以一致的方式促进医疗保健提供者、患者和家属之间的沟通。对于 EPPCP，没有标准的命名法，也没有指南来规范实践，存在着多样性的观点。需要进一步进行大规模前瞻性研究，以更好地了解 EPPCP 的病理生理机制、最佳管理策略、预后意义和临床报告。
