CBS 2019
CBSMD教育中心
中 文

Acute Coronary Syndrom

Abstract

Recommended Article

Current Smoking and Prognosis After Acute ST-Segment Elevation Myocardial Infarction: New Pathophysiological Insights Association between Coronary Collaterals and Myocardial Viability in Patients with a Chronic Total Occlusion Effect of Lipoprotein (a) Levels on Long-term Cardiovascular Outcomes in Patients with Myocardial Infarction with Nonobstructive Coronary Arteries Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction Long-Term Outcomes of Patients With Late Presentation of ST-Segment Elevation Myocardial Infarction Clinical Characteristics and Outcomes of STEMI Patients With Cardiogenic Shock and Cardiac Arrest Intra-aortic balloon counterpulsation in acute myocardial infarction complicated by cardiogenic shock (IABP-SHOCK II): final 12 month results of a randomised, open-label trial Macrophage MST1/2 Disruption Impairs Post-Infarction Cardiac Repair via LTB4

Review ArticleVolume 13, Issue 1, January 2020

JOURNAL:JACC: Cardiovascular Interventions Article Link

Refractory Angina: From Pathophysiology to New Therapeutic Nonpharmacological Technologies

G Gallone, L Baldetti, G Tzanis et al. Keywords: cell therapy; coronary sinus reduce; renhanced external counterpulsation; extracorporeal shockwave myocardial revascularization; neuromodulation; refractory angina

ABSTRACT


Despite optimal combination of guideline-directed anti-ischemic therapies and myocardial revascularization, a substantial proportion of patients with stable coronary artery disease continues to experience disabling symptoms and is often referred as “no-option.” The appraisal of the pathways linking ischemia to symptom perception indicates a complex model of heart-brain interactions in the generation of the subjective anginal experience and inspired novel approaches that may be clinically effective in alleviating the angina burden of this population. Conversely, the prevailing ischemia-centered view of angina, with the focus on traditional myocardial revascularization as the sole option to address ischemia on top of medical therapy, hinders the experimental characterization and broad-scale clinical implementation of strongly needed therapeutic options. The interventionist, often the first physician to establish the diagnosis of refractory angina pectoris (RAP) following coronary angiography, should be aware of the numerous emerging technologies with the potential to improve quality of life in the growing population of RAP patients. This review describes the current landscape and the future perspectives on nonpharmacological treatment technologies for patients with RAP, with a view on the underlying physiopathological rationale and current clinical evidence.