Review ArticleVolume 63, Issue 3, May–June 2020, Pages 233-242
JOURNAL:Prog Cardiovasc Dis. Article Link
Role of endothelial dysfunction in determining angina after percutaneous coronary intervention: Learning from pathophysiology to optimize treatment
F Mangiacapraa; MGDel Buonobc; A Abbate et al.
Keywords:
endothelial dysfunction; angina; PCI; recurrent angina; microvascular dysfunction
ABSTRACT
Endothelial dysfunction (EnD) is a hallmark feature of coronary artery
disease (CAD), representing the key early step of atherosclerotic plaque
development and progression. Percutaneous coronary intervention (PCI)
is performed daily worldwide to treat symptomatic CAD, however a
consistent proportion of patients remain symptomatic for angina despite
otherwise successful revascularization. EnD plays a central role in the
mechanisms of post-PCI angina, as it is strictly associated with both
structural and functional abnormalities in the coronary arteries that
may persist, or even accentuate, following PCI. The assessment of
endothelial function in patients undergoing PCI might help to identify
those patients at higher risk of future cardiovascular events and
recurrent/persistent angina who might therefore benefit more from an
intensive treatment. In this review, we address the role of EnD in
determining angina after PCI, discussing its pathophysiological
mechanisms, diagnostic approaches and therapeutic perspectives.