Therapy After Percutaneous Coronary Intervention in Chronic Coronary Disease: A Practical Review for Internal Medicine and Interventional Cardiology

Percutaneous coronary intervention (PCI) is a central procedure in modern cardiology, but the long-term prognosis of patients with chronic coronary disease is determined not only by mechanical revascularization. Durable benefit after PCI depends on the systematic control of atherosclerotic risk, correct selection and duration of antiplatelet therapy, intensive lipid lowering, blood pressure and glycemic optimization, antianginal treatment, rehabilitation, and patient adherence. Recent European and American recommendations increasingly frame coronary artery disease as a chronic, multidisciplinary condition that requires coordinated follow-up after the catheterization laboratory. This review summarizes current evidence and provides a practical outpatient algorithm for therapy departments and interventional cardiology services managing adults after PCI. The article focuses on five clinically important domains: antithrombotic therapy, lipid-lowering escalation, antianginal and hemodynamic treatment, cardiometabolic risk modification, and structured post-discharge follow-up. A stepwise checklist is proposed for visits at 7-14 days, 1-3 months, and 6-12 months after PCI. The practical aim is to reduce fragmentation of care, improve documentation of treatment goals, and help physicians translate guideline recommendations into everyday practice. The proposed approach is particularly relevant for patients with diabetes, hypertension, chronic kidney disease, obesity, previous myocardial infarction, multivessel coronary disease, and high bleeding risk, in whom a single uniform post-PCI prescription is insufficient.

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