MICROVASCULAR ANGINA IN PATIENTS AFTER PERCUTANEOUS CORONARY INTERVENTION
DOI:
https://doi.org/10.32782/2226-2008-2024-6-4Keywords:
microvascular angina, percutaneous coronary intervention, anxietyAbstract
Coronary heart disease (CHD) remains a leading cause of mortality and disability among adults worldwide. Percutaneous coronary intervention (PCI) significantly improves the treatment of CHD, reducing disability and mortality. However, some patients continue to experience ischemic symptoms after successful PCI, which may be due to coronary microvascular dysfunction (MVD) – a key mechanism of microvascular angina. The aim of the study – to assess coronary blood flow reserve and overall anxiety levels in patients with persistent myocardial ischemia after PCI. Materials and methods. The study included 65 patients diagnosed with stenosing atherosclerosis of the coronary arteries, who were treated at the National Institute of Cardiovascular Surgery in Ukraine in 2023. Despite successful PCI, some patients continued to exhibit ischemic symptoms post-procedure. Additional examinations, including exercise testing, stress echocardiography, and dipyridamole-enhanced echocardiography, were performed to evaluate coronary blood flow reserve (CFR). Anxiety levels were assessed using the “anxiety” subscale of the Hospital Anxiety and Depression Scale (HADS). Results. All patients in the clinical group had a CFR below 2, confirming the presence of coronary MVD. The average HADS score in the clinical group was 10.5±1.1, indicating higher anxiety levels compared to the control group, where the average score was 6.9±0.6 (p<0.05). Clinically significant anxiety (≥11 points) was significantly more common in patients with microvascular angina than in the control group (chi-square = 13.1, p<0.05). Conclusions. Residual myocardial ischemia in patients with CHD and stenosing coronary atherosclerosis after PCI is often due to microvascular angina. Clinically significant anxiety was observed in 35.4% of patients with microvascular angina, significantly higher than in the control group, highlighting the importance of addressing anxiety in the comprehensive management of these patients.
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