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Inflammation during Percutaneous Coronary Intervention-Prognostic Value, Mechanisms and Therapeutic Targets

Bradley Tucker1,2,3, Kaivan Vaidya2,4, Blake J Cochran3

  • 1Heart Research Institute, 7 Eliza St., Newtown 2042, Australia.

Cells
|July 2, 2021
PubMed

Insights

Periprocedural myocardial infarction (MI) after percutaneous coronary intervention (PCI) is linked to inflammation. Anti-inflammatory treatments like colchicine may improve patient outcomes and reduce mortality.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Inflammation Research

Background:

  • Periprocedural myocardial injury and myocardial infarction (MI) are significant complications following percutaneous coronary intervention (PCI).
  • Elevated inflammation levels pre-, intra-, and post-PCI correlate with increased myonecrosis, future ischemic events, heart failure, and cardiac mortality.
  • PCI triggers an acute inflammatory response due to endothelial damage, plaque debris release, and reperfusion injury.

Purpose of the Study:

  • To review the epidemiology and pathophysiology of periprocedural MI.
  • To evaluate the prognostic significance of inflammation in the periprocedural setting.
  • To discuss the potential of anti-inflammatory agents, such as colchicine, for improving PCI outcomes.

Main Methods:

  • Literature review of preclinical and observational data.
  • Analysis of mechanisms driving PCI-induced inflammation.
  • Discussion of anti-inflammatory treatment strategies.

Main Results:

  • High levels of inflammation are consistently associated with adverse periprocedural and long-term outcomes after PCI.
  • PCI itself is an inflammatory stimulus, contributing to myocardial injury.
  • Anti-inflammatory therapies represent a potential therapeutic avenue.

Conclusions:

  • Inflammation plays a critical role in periprocedural MI and subsequent adverse events.
  • Targeting inflammation peri-PCI may mitigate myocardial injury and improve clinical outcomes.
  • Further research into anti-inflammatory treatments for PCI is warranted.

Keywords:
angioplastyatherosclerosiscardiovascular diseaseinflammationmyocardial infarctionpercutaneous coronary interventionperiprocedural myocardial infarction

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