title: Postinfarction angina.
abstract: In conclusion, the PIA patient is at high risk, with higher early as well as late mortality. The pathophysiology of PIA is complex and may vary from patient to patient. The concepts of ischemia at a distance and ischemia in the infarct zone have led to a better understanding of early PIA. Coronary spasm may play an important role in most PIA patients as in the general population of patients with angina pectoris. Medical therapy is efficacious in many, although it may on rare occasion aggravate myocardial ischemia. Urgent coronary arteriography is generally safe and should be performed as soon as possible for medically refractory PIA. CABG appears to be safe in experienced hands, but its timing must be individualized. The IABP should be reserved for more unstable patients for fear of vascular complications. Randomized controlled trials such as the BARI Trial will further compare PTCA with CABG.
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D000328:Adult; D000787:Angina Pectoris / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D000800:Angioplasty, Balloon; D000925:Anticoagulants / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003097:Collateral Circulation; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003937:Diagnosis, Differential; D005343:Fibrinolytic Agents / Q000008:administration & dosage; D005500:Follow-Up Studies; D006321:Heart / Q000503:physiopathology; D006801:Humans; D007423:Intra-Aortic Balloon Pumping; D008297:Male; D009203:Myocardial Infarction / Q000150:complications*; D005996:Nitroglycerin / Q000627:therapeutic use; D011379:Prognosis; D012008:Recurrence
chemical_list: D000319:Adrenergic beta-Antagonists; D000925:Anticoagulants; D002121:Calcium Channel Blockers; D005343:Fibrinolytic Agents; D005996:Nitroglycerin