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Role of endothelial dysfunction in determining angina after percutaneous coronary intervention: Learning from

Fabio Mangiacapra1, Marco Giuseppe Del Buono2, Antonio Abbate3

  • 1Unit of Cardiovascular Science, Campus Bio-Medico University, Rome, Italy.

Progress in Cardiovascular Diseases
|February 17, 2020
PubMed

Insights

Endothelial dysfunction (EnD) is a key factor in coronary artery disease (CAD) and can cause persistent angina after percutaneous coronary intervention (PCI). Assessing EnD may identify high-risk patients needing intensive treatment.

Area of Science:

  • Cardiovascular Medicine
  • Vascular Biology
  • Interventional Cardiology

Background:

  • Endothelial dysfunction (EnD) is a primary driver of coronary artery disease (CAD) pathogenesis and atherosclerotic plaque development.
  • Percutaneous coronary intervention (PCI) is a common treatment for symptomatic CAD, yet a significant number of patients experience persistent angina post-procedure.
  • EnD contributes to persistent angina after PCI through persistent structural and functional coronary artery abnormalities.

Purpose of the Study:

  • To review the role of endothelial dysfunction (EnD) in causing angina following percutaneous coronary intervention (PCI).
  • To discuss the pathophysiological mechanisms, diagnostic methods, and therapeutic strategies related to EnD and post-PCI angina.

Main Methods:

  • Literature review focusing on endothelial function, coronary artery disease, percutaneous coronary intervention, and angina.
  • Analysis of pathophysiological mechanisms linking EnD to post-PCI symptoms.
  • Evaluation of current diagnostic approaches and emerging therapeutic perspectives for EnD.

Main Results:

  • Endothelial dysfunction is intrinsically linked to the development and progression of CAD.
  • Persistent EnD post-PCI contributes significantly to angina symptoms, even after successful revascularization.
  • Assessment of endothelial function may stratify patients for risk of cardiovascular events and recurrent angina.

Conclusions:

  • Endothelial dysfunction is a critical determinant of angina following PCI.
  • Identifying and managing EnD is crucial for improving outcomes in patients undergoing PCI.
  • Further research into diagnostic and therapeutic interventions targeting EnD is warranted to reduce persistent angina and cardiovascular risk.

Keywords:
AnginaEndothelial dysfunctionMicrovascular dysfunctionPercutaneous coronary interventionRecurrent angina

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