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Published on: September 27, 2013
Therapeutic angiogenesis
A Durairaj1, A Mehra, R P Singh
1Division of Cardiology, University of Southern California School of Medicine, Los Angeles, California, USA.
Insights
Coronary artery disease (CAD) is a major health issue. For patients unsuitable for traditional revascularization, therapeutic angiogenesis offers a promising new treatment to improve heart blood supply.
Area of Science:
- Cardiovascular Medicine
- Regenerative Medicine
Background:
- Coronary artery disease (CAD) is a leading cause of death globally.
- Current treatments include risk factor modification, medical therapy, and revascularization procedures like percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG).
- A subset of patients with complex CAD are not candidates for conventional revascularization.
Purpose of the Study:
- To introduce therapeutic angiogenesis as a novel treatment strategy.
- To address the unmet need for treating patients with diffuse or complex coronary artery disease unsuitable for standard revascularization.
- To highlight the potential of therapeutic angiogenesis in improving myocardial blood supply and alleviating symptoms.
Main Methods:
- Review of current treatment approaches for coronary artery disease.
- Analysis of patient populations unsuitable for PCI or CABG.
- Introduction of therapeutic angiogenesis as an emerging medical technology.
Main Results:
- Approximately 12% of patients in a tertiary referral center analysis were unsuitable for revascularization.
- The number of patients ineligible for revascularization is projected to increase.
- Therapeutic angiogenesis presents a potential solution for this growing patient group.
Conclusions:
- Therapeutic angiogenesis offers a promising new avenue for treating ischemic heart disease.
- This approach aims to improve blood flow to the heart muscle in patients with limited treatment options.
- It holds potential for symptomatic relief in a significant and expanding patient population.
Abstract:
Coronary artery disease remains the leading cause of morbidity and mortality in the Western world. The initial approach to treatment involves risk factor modification in an attempt to halt or slow the progression of disease. Treatment of symptomatic disease aims at reducing myocardial oxygen demand with medical therapy. When this fails, revascularization to restore blood supply by percutaneous coronary intervention or coronary artery bypass grafting is often necessary. Advances in medical technology have both increased the success rate and lowered the morbidity and mortality of these 2 procedures. However, a significant number of patients have diffuse coronary artery disease, absent conduits after previous bypass surgery, small distal vessels, and comorbidities that may preclude either procedure. In a recent analysis of 500 consecutive patients at a tertiary referral center, approximately 12% of these patients fell into this category (1). With the widespread use of revascularization, it is likely that the number of patients who will not be suitable for revascularization in the future will increase significantly. Therapeutic angiogenesis is an exciting new method of improving blood supply to an ischemic segment of the myocardium to provide symptomatic relief to a large and growing population of patients.
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