Angina after PCI in Focal and Diffuse Coronary Artery Disease: a review

After percutaneous coronary intervention, an increase in fractional flow reserve often correlates with patients experiencing improvements in angina. However, focal and diffuse coronary artery disease patterns influence the change in fractional flow reserve, which may influence angina improvement. 103 patients were used in this study, with no baseline differences in their coronary artery disease characteristics, whether focal or diffuse. It was found that those with focal disease experienced larger increases in fractional flow reserve, and residual angina was often found in patients with diffuse disease post-percutaneous coronary intervention – it was almost twice as common. Therefore, the baseline coronary artery disease pattern appears to be able to predict the likelihood of angina improvement as percutaneous coronary intervention.

This review by Collet C et al. aimed to explore the differences in improvement of angina symptoms after percutaneous coronary interventions in patients with focal and diffuse disease patterns.

Key learnings

Whether the disease pattern of coronary artery disease is focal or diffuse must be taken into account by clinicians when considering percutaneous coronary intervention. Future trials will allow for a better understanding of the impact of these strategies, to find the most effective method of disease management.