Monthly Update: Vascular restenosis: A disease in search of therapy: Cardiovascular & Renal

Abstract

The evolution of interventional cardiology for treatment of coronary artery disease (CAD) has had a significant impact on morbidity and mortality from CAD [1]. In particular, percutaneous transluminal coronary angioplasty (PTCA) has become a popular intervention, as over 350,000 procedures are performed in the United States annually for angina, unstable angina and acute myocardial infarction [2]. However, much of the initial improvement in coronary blood flow produced by PTCA is short-lived, as 30% - 50% of the patients experience coronary vascular restenosis (i.e., intimal thickening of the coronary artery) six to twelve months following PTCA. Restenosis of the coronary artery often precipitates the need for additional medical or interventional treatment, resulting in further morbidity, mortality and cost. Thus, the process of vascular restenosis following PTCA is an excellent example of a therapy-mediated disorder which diminishes significantly the initial success of PTCA.