Is a new coronary angiography necessary in patients with previous myocardial revascularization surgery who present with a new ischemic event?

Abstract

In the usual medical practice, not only cardiologists, but also other medical specialties frequently are consulted by chest pain, either with the diagnosis of acute myocardial infarction or unstable angina, of which the diagnosis and treatment algorithm to follow is very clear. In patients with previous myocardial revascularization surgery who present with a new ischemic event, coronary angiography is debated due to the fact that it adds morbidity and mortality to a fragile patient and the impossibility of angioplasty due to extensive coronary disease or calcified vessels. Therefore, they do not always end undergoing an invasive treatment such as angioplasty, raising the question: is coronary angiography necessary in these patients?