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...

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Bibliographic Details
Published in:Cells (Basel, Switzerland) Switzerland), 2021-06, Vol.10 (6), p.1391
Main Authors: Tucker, Bradley, Vaidya, Kaivan, Cochran, Blake J., Patel, Sanjay
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angioplasty
atherosclerosis
Cardiovascular disease
Colchicine
Congestive heart failure
Coronary vessels
Embolization
Epidemiology
Heart attacks
Inflammation
Mortality
Myocardial infarction
Myonecrosis
Pathophysiology
percutaneous coronary intervention
Population
Reperfusion
Review
Stents
Therapeutic targets
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Summary: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.
ISSN:2073-4409
2073-4409
DOI:10.3390/cells10061391