21507_Optimizing Management of Recurrent Angina after PCI

Deepak Bhatt, MD, MPH, FSCAI (Chair); Duane Pinto, MD, FSCAI and Peter Stone, MD, MPH conduct a state-of-the-art discussion and case study on recurrent angina after PCI

Despite the widespread use and continuous evolution of revascularization strategies and optimal medical therapy for CAD, the incidence of recurrent angina after PCI remains high (occurring in 20% to 34% of patients in the first year after PCI), with frequent need for repeat revascularization and hospitalizations. Careful assessment is recommended to differentiate between non-cardiac and cardiac causes of recurrent angina after PCI; in the case of the latter, recurrent angina occurrence can be related to structural or functional causes. Even though a complete diagnostic algorithm has not been validated, ECG exercise testing, stress imaging and invasive assessment of coronary blood flow and coronary vaso-motion may be required. When repeated coronary revascularization is not indicated, therapeutic approaches should aim at targeting the underlying mechanism for the patient’s symptoms using a variety of antianginal drugs. Awareness of similarities and differences between antianginal drugs is important for appropriate selection of therapy; in addition to drug properties and clinical data, patient profile and practice guidelines should be considered. In this program, state-of-the-art presentations on recurrent angina after PCI and antianginal medications will be followed by a challenging interactive case presentation, enabling attendees to provide input and experts to elaborate best patient care.

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