Key result
Among MI patients treated with PCI who had angina at 6 weeks, 33.1% reported persistent angina at 1 year, yet only 31.2% of these patients were prescribed non-β-blocker antianginal medications.
Cohort (n=10,870)
Yes
Despite persistent angina in one-third of post-MI patients treated with PCI, non-beta-blocker antianginal medications are significantly underutilized in clinical practice.
Persistent angina post-PCI MI linked to higher utilization; leaves open optimal management strategies in real-world cohorts.
BACKGROUND: Angina has important implications for patients' quality of life and healthcare utilization. Angina management after acute myocardial infarction (MI) treated with percutaneous coronary intervention (PCI) is unknown. METHODS AND RESULTS: TRANSLATE-ACS (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) was a longitudinal study of MI patients treated with percutaneous coronary intervention at 233 US hospitals from 2010 to 2012. Among patients with self-reported angina at 6 weeks post-MI, we described patterns of angina and antianginal medication use through 1 year postdischarge. Of 10 870 percutaneous coronary intervention-treated MI patients, 3190 (29.3%) reported angina symptoms at 6 weeks post-MI; of these, 658 (20.6%) had daily/weekly angina while 2532 (79.4%) had monthly angina. Among patients with 6-week angina, 2936 (92.0%) received β-blockers during the 1 year post-MI, yet only 743 (23.3%) were treated with other antianginal medications. At 1 year, 1056 patients (33.1%) with 6-week angina reported persistent angina symptoms. Of these, only 31.2% had been prescribed non-β-blocker antianginal medications at any time in the past year. Among patients undergoing revascularization during follow-up, only 25.9% were on ≥1 non-β-blocker anti-anginal medication at the time of the procedure. CONCLUSIONS: Angina is present in one third of percutaneous coronary intervention-treated MI patients as early as 6 weeks after discharge, and many of these patients have persistent angina at 1 year. Non-β-blocker antianginal medications are infrequently used in these patients, even among those with persistent angina and those undergoing revascularization.
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Fanaroff et al. (2017) conducted a cohort in Acute myocardial infarction treated with percutaneous coronary intervention (n=10,870). Post-MI angina and antianginal medication use was evaluated on Persistent angina symptoms at 1 year among patients with 6-week angina. Among MI patients treated with PCI who had angina at 6 weeks, 33.1% reported persistent angina at 1 year, yet only 31.2% of these patients were prescribed non-β-blocker antianginal medications.
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