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Complex PCI procedures: challenges for the interventional cardiologist Management of Asymptomatic Severe Aortic Stenosis: Evolving Concepts in Timing of Valve Replacement A Controlled Trial of Rivaroxaban After Transcatheter Aortic-Valve Replacement Comparison of Early Surgical or Transcatheter Aortic Valve Replacement Versus Conservative Management in Low-Flow, Low-Gradient Aortic Stenosis Using Inverse Probability of Treatment Weighting: Results From the TOPAS Prospective Observational Cohort Study Anticoagulation After Surgical or Transcatheter Bioprosthetic Aortic Valve Replacement Balloon Aortic Valvuloplasty as a Bridge to Aortic Valve Replacement: A Contemporary Nationwide Perspective A Review of the Role of Breast Arterial Calcification for Cardiovascular Risk Stratification in Women Association of Coronary Artery Calcium With Long-term, Cause-Specific Mortality Among Young Adults Pulmonary arterial hypertension in congenital heart disease: an epidemiologic perspective from a Dutch registry Expansion or contraction of stenting in coronary artery disease?

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.