CBS 2019
CBSMD教育中心
中 文

Acute Coronary Syndrom

Abstract

Recommended Article

Sex differences in discharge destination following acute myocardial infarction Randomized trial of complete versus lesion-only revascularization in patients undergoing primary percutaneous coronary intervention for STEMI and multivessel disease: the CvLPRIT trial Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection Myocardial Infarction in Young Women Incidence and prognostic implication of unrecognized myocardial scar characterized by cardiac magnetic resonance in diabetic patients without clinical evidence of myocardial infarction Prevalence and Prognosis of Unrecognized Myocardial Infarction Determined by Cardiac Magnetic Resonance in Older Adults Successful catheter ablation of electrical storm after myocardial infarction

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.