Role of angiogenesis in cardiovascular disease: a critical appraisal

Area of Science:

• Cardiovascular Research
• Vascular Biology
• Medical Science

Background:

• The role of angiogenesis in atherosclerosis and cardiovascular diseases remains controversial.
• Angiogenic factors are considered for treating ischemic heart disease but may promote atherosclerotic lesion growth and plaque instability.

Purpose of the Study:

• To critically review evidence on angiogenesis and angiogenic factors in atherosclerosis and neointima formation.
• To evaluate the suitability of animal models for studying angiogenesis in these conditions.
• To contextualize findings within vascular endothelial growth factor (VEGF) biology and clinical trial outcomes.

Main Methods:

• Critical review of existing literature on angiogenesis in atherosclerosis.
• Analysis of studies focusing on vascular endothelial growth factor (VEGF).
• Consideration of clinical trial data for angiogenic therapies in ischemic heart disease.

Main Results:

• Microvessels are present in advanced human atherosclerotic plaques.
• Angiogenesis may contribute to neointimal growth but is not essential for initial intimal thickening.
• Clinical trials of pro- and anti-angiogenic therapies show limited success for cardiovascular disease.

Conclusions:

• The central role of angiogenesis in atherosclerosis development and plaque instability remains unclear.
• Inhibiting angiogenesis is unlikely to be a viable therapeutic strategy for cardiovascular diseases based on current evidence.