Angina After PCI: a Systems Medicine Study

When you have chest pain, called angina, it's often because your heart isn't getting enough blood. Doctors can open blocked heart blood vessels using a procedure called an angioplasty. This involves a tiny balloon to clear the blockage, and often a small metal tube called a stent is left behind to keep the vessel open. Sometimes, doctors use a drug-coated balloon instead of a stent to prevent the vessel from narrowing again. However, some people still experience angina even after having this procedure, and occasionally their symptoms can get worse.

This study aims to understand why angina might continue or come back after an angioplasty. We want to find out what causes this ongoing discomfort, how it affects patients' lives, and what impact it has on the NHS. By doing this, we hope to identify which patients will most benefit from a stent and avoid giving this procedure to those who might not need it, or for whom it might not be the best solution.

We plan to involve up to 600 patients across different hospitals in the UK over five years. All these patients will have angina and are due to have an angioplasty. We will give them an MRI scan of their heart before the procedure. After their angioplasty, we will follow them for a year to see if their angina comes back. We'll use special tests to look at how well the small blood vessels in their heart are working and how much plaque (fatty deposits) is left after the angioplasty. For patients who do get angina again, instead of having another invasive X-ray of their heart, we'll ask them to have another MRI scan. We want to see if this MRI scan can give us clearer information than a traditional X-ray, to help doctors decide on the best next steps.