Abstract
Since the introduction of coronary vessel scaffold by metallic stent, percutaneous coronary intervention has become widely performed all over the world. Although drug-eluting stent technology has further decrease the incidence of in-stent restenosis, there still remaining issues related to stent implantation. Vessel inflammation is one of the causes that may be related to stent restenosis as well as stent thrombosis. Therefore, systemic therapies targeting inflammation emerged as adjunctive pharmacological intervention to improve outcome. Statins, corticosteroids, antiplatelets, and immunosuppresive or anti-cancer drugs are reported to favorably impact outcome after bare-metal stent implantation. In type 2 diabetic patients, pioglitazone may be the most promising drug that can lower neointimal proliferation and, as a result, lower incidence of restenosis and target lesion revascularization. On the other hand, several new stent platforms that might decrease inflammatory response after drug-eluting stent implantation have been introduced. Because durable polymer used in the first generation drug-eluting stents are recognized to be responsible for unfavorable vessel response, biocompatible or bioabsorbable polymer has been introduce and already used clinically. Furthermore, polymer-free drug-eluting stent and bioresorbable scaffold are under investigation. Although vessel inflammation may be reduced by using these new drug-eluting stents or scaffold, long-term impact needs to be investigated further.
Keywords: Coronary stent, inflammation, systemic drug therapies.
Current Vascular Pharmacology
Title:Therapies Targeting Inflammation After Stent Implantation
Volume: 11 Issue: 4
Author(s): Hiroyuki Okura, Tsutomu Takagi and Kiyoshi Yoshida
Affiliation:
Keywords: Coronary stent, inflammation, systemic drug therapies.
Abstract: Since the introduction of coronary vessel scaffold by metallic stent, percutaneous coronary intervention has become widely performed all over the world. Although drug-eluting stent technology has further decrease the incidence of in-stent restenosis, there still remaining issues related to stent implantation. Vessel inflammation is one of the causes that may be related to stent restenosis as well as stent thrombosis. Therefore, systemic therapies targeting inflammation emerged as adjunctive pharmacological intervention to improve outcome. Statins, corticosteroids, antiplatelets, and immunosuppresive or anti-cancer drugs are reported to favorably impact outcome after bare-metal stent implantation. In type 2 diabetic patients, pioglitazone may be the most promising drug that can lower neointimal proliferation and, as a result, lower incidence of restenosis and target lesion revascularization. On the other hand, several new stent platforms that might decrease inflammatory response after drug-eluting stent implantation have been introduced. Because durable polymer used in the first generation drug-eluting stents are recognized to be responsible for unfavorable vessel response, biocompatible or bioabsorbable polymer has been introduce and already used clinically. Furthermore, polymer-free drug-eluting stent and bioresorbable scaffold are under investigation. Although vessel inflammation may be reduced by using these new drug-eluting stents or scaffold, long-term impact needs to be investigated further.
Export Options
About this article
Cite this article as:
Okura Hiroyuki, Takagi Tsutomu and Yoshida Kiyoshi, Therapies Targeting Inflammation After Stent Implantation, Current Vascular Pharmacology 2013; 11 (4) . https://dx.doi.org/10.2174/1570161111311040004
DOI https://dx.doi.org/10.2174/1570161111311040004 |
Print ISSN 1570-1611 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6212 |
Call for Papers in Thematic Issues
Ischemic Cardiovascular Diseases: Mechanisms, Diagnosis and Therapy
Ischemic cardiovascular disease includes myocardial infarction, coronary atherosclerotic heart disease, angina pectoris, etc., constitute the leading cause of patient mortality by preventing tissues from getting sufficient oxygen and nutrients. Ischemic heart disease, as a clinical condition, is characterized by myocardial ischemia, causing an imbalance between myocardial blood supply and demand, ...read more
TREATMENT OF CARDIOVASCULAR DISEASE IN CHRONIC AND END STAGE KIDNEY DISEASE
Cardiovascular disease still remains the leading cause of death in Chronic and End Stage Kidney Disease, accounting for more than half of all deaths in dialysis patients. During the past decade, research has been focused on novel therapeutic agents that might delay or even reverse cardiovascular disease and vascular calcification, ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
- Announcements
Related Articles
-
Inflammatory Biomarkers in Peripheral Artery Disease: Diagnosis, Prognosis, and Therapeutic Challenges
Current Medicinal Chemistry Glucokinase Activators for the Potential Treatment of Type 2 Diabetes
Current Topics in Medicinal Chemistry Vitamins and Cognition: A Nutrigenomics Perspective
Current Nutrition & Food Science High Throughput Screening for Drug Discovery of Autophagy Modulators
Combinatorial Chemistry & High Throughput Screening Non Smoking for Successful Aging: Therapeutic Perspectives
Current Pharmaceutical Design Promising Anti-stroke Signature of Voglibose: Investigation through In- Silico Molecular Docking and Virtual Screening in In-Vivo Animal Studies
Current Gene Therapy Cilostazol in the Management of Atherosclerosis
Current Vascular Pharmacology Low Molecular Weight and Oligomeric Chitosans and Their Bioactivities
Current Topics in Medicinal Chemistry The Role of Trophoblast Nutrient and Ion Transporters in the Development of Pregnancy Complications and Adult Disease
Current Vascular Pharmacology Editorial: Natural Compounds and Their Derivatives as a Source of Promising Drugs for Diabetes and Insulin Resistance
Current Drug Targets Pharmacological Applications of Antioxidants: Lights and Shadows
Current Drug Targets Application of Nanotechnology in Acupuncture
Current Nanoscience Prediction and Diagnosis of Post Transplant Diabetes
Current Diabetes Reviews Survey of Mortality Due to Influenza A in North of Iran, 2015-2016
Current Respiratory Medicine Reviews Predementia and Dementia Syndromes: Possible Role of Lipoprotein Metabolism
Vascular Disease Prevention (Discontinued) Results of Controlled Clinical Trials Comparing “Guideline Exposed” and “Guideline Naive” Physicians in the Treatment of Depression, Hypertension,and Diabetes: What can be Learned?
Current Psychiatry Reviews Management of Primary Aldosteronism: Its Complications and Their Outcomes After Treatment
Current Vascular Pharmacology Primary and Secondary Stroke Prevention with Antiplatelet Drugs
Current Pharmaceutical Design Visual and Quantitative Assessment of COVID-19 Pneumonia on Chest CT: The Relationship with Disease Severity and Clinical Findings
Current Medical Imaging Niemann-Pick C1-Like 1 (NPC1L1) Inhibition and Cardiovascular Diseases
Current Medicinal Chemistry