Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets
Periprocedural myocardial injury and myocardial infarction (MI) are not infrequent complications of percutaneous coronary intervention (PCI) and are associated with greater short- and long-term mortality. There is an abundance of preclinical and observational data demonstrating that high levels of p...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-06-01
|
| Series: | Cells |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2073-4409/10/6/1391 |
| _version_ | 1797531351148134400 |
|---|---|
| author | Bradley Tucker Kaivan Vaidya Blake J. Cochran Sanjay Patel |
| author_facet | Bradley Tucker Kaivan Vaidya Blake J. Cochran Sanjay Patel |
| author_sort | Bradley Tucker |
| collection | DOAJ |
| description | Periprocedural myocardial injury and myocardial infarction (MI) are not infrequent complications of percutaneous coronary intervention (PCI) and are associated with greater short- and long-term mortality. There is an abundance of preclinical and observational data demonstrating that high levels of pre-, intra- and post-procedural inflammation are associated with a higher incidence of periprocedural myonecrosis as well as future ischaemic events, heart failure hospitalisations and cardiac-related mortality. Beyond inflammation associated with the underlying coronary pathology, PCI itself elicits an acute inflammatory response. PCI-induced inflammation is driven by a combination of direct endothelial damage, liberation of intra-plaque proinflammatory debris and reperfusion injury. Therefore, anti-inflammatory medications, such as colchicine, may provide a novel means of improving PCI outcomes in both the short- and long-term. This review summarises periprocedural MI epidemiology and pathophysiology, evaluates the prognostic value of pre-, intra- and post-procedural inflammation, dissects the mechanisms involved in the acute inflammatory response to PCI and discusses the potential for periprocedural anti-inflammatory treatment. |
| first_indexed | 2024-03-10T10:42:32Z |
| format | Article |
| id | doaj.art-ff17c1e218204313b27efd88dc061ee5 |
| institution | Directory Open Access Journal |
| issn | 2073-4409 |
| language | English |
| last_indexed | 2024-03-10T10:42:32Z |
| publishDate | 2021-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cells |
| spelling | doaj.art-ff17c1e218204313b27efd88dc061ee52023-11-21T22:51:16ZengMDPI AGCells2073-44092021-06-01106139110.3390/cells10061391Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic TargetsBradley Tucker0Kaivan Vaidya1Blake J. Cochran2Sanjay Patel3Heart Research Institute, 7 Eliza St., Newtown 2042, AustraliaSydney Medical School, University of Sydney, Camperdown 2050, AustraliaSchool of Medical Sciences, University of New South Wales, Kensington 2052, AustraliaHeart Research Institute, 7 Eliza St., Newtown 2042, AustraliaPeriprocedural myocardial injury and myocardial infarction (MI) are not infrequent complications of percutaneous coronary intervention (PCI) and are associated with greater short- and long-term mortality. There is an abundance of preclinical and observational data demonstrating that high levels of pre-, intra- and post-procedural inflammation are associated with a higher incidence of periprocedural myonecrosis as well as future ischaemic events, heart failure hospitalisations and cardiac-related mortality. Beyond inflammation associated with the underlying coronary pathology, PCI itself elicits an acute inflammatory response. PCI-induced inflammation is driven by a combination of direct endothelial damage, liberation of intra-plaque proinflammatory debris and reperfusion injury. Therefore, anti-inflammatory medications, such as colchicine, may provide a novel means of improving PCI outcomes in both the short- and long-term. This review summarises periprocedural MI epidemiology and pathophysiology, evaluates the prognostic value of pre-, intra- and post-procedural inflammation, dissects the mechanisms involved in the acute inflammatory response to PCI and discusses the potential for periprocedural anti-inflammatory treatment.https://www.mdpi.com/2073-4409/10/6/1391atherosclerosisinflammationcardiovascular diseasepercutaneous coronary interventionangioplastymyocardial infarction |
| spellingShingle | Bradley Tucker Kaivan Vaidya Blake J. Cochran Sanjay Patel Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets Cells atherosclerosis inflammation cardiovascular disease percutaneous coronary intervention angioplasty myocardial infarction |
| title | Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets |
| title_full | Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets |
| title_fullStr | Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets |
| title_full_unstemmed | Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets |
| title_short | Inflammation during Percutaneous Coronary Intervention—Prognostic Value, Mechanisms and Therapeutic Targets |
| title_sort | inflammation during percutaneous coronary intervention prognostic value mechanisms and therapeutic targets |
| topic | atherosclerosis inflammation cardiovascular disease percutaneous coronary intervention angioplasty myocardial infarction |
| url | https://www.mdpi.com/2073-4409/10/6/1391 |
| work_keys_str_mv | AT bradleytucker inflammationduringpercutaneouscoronaryinterventionprognosticvaluemechanismsandtherapeutictargets AT kaivanvaidya inflammationduringpercutaneouscoronaryinterventionprognosticvaluemechanismsandtherapeutictargets AT blakejcochran inflammationduringpercutaneouscoronaryinterventionprognosticvaluemechanismsandtherapeutictargets AT sanjaypatel inflammationduringpercutaneouscoronaryinterventionprognosticvaluemechanismsandtherapeutictargets |