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Another Nail in the Coffin for Intra-Aortic Balloon Counterpulsion in Acute Myocardial Infarction With Cardiogenic Shock Invasive Management of Acute Myocardial Infarction Complicated by Cardiogenic Shock: A Scientific Statement From the American Heart Association Appropriate Use Criteria and Health Status Outcomes Following Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the OPEN-CTO Registry Genetic dysregulation of endothelin-1 is implicated in coronary microvascular dysfunction Outcome of Applying the ESC 0/1-hour Algorithm in Patients With Suspected Myocardial Infarction Mechanisms and diagnostic evaluation of persistent or recurrent angina following percutaneous coronary revascularization Long-term outcomes after myocardial infarction in middle-aged and older patients with congenital heart disease-a nationwide study A Test in Context: E/A and E/e' to Assess Diastolic Dysfunction and LV Filling Pressure Invasive Versus Medical Management in Patients With Prior Coronary Artery Bypass Surgery With a Non-ST Segment Elevation Acute Coronary Syndrome: A Pilot Randomized Controlled Trial Association of Body Mass Index With Lifetime Risk of Cardiovascular Disease and Compression of Morbidity

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.