Molecular and cellular basis of restenosis after percutaneous coronary intervention: the intertwining roles of platelets, leukocytes, and the coagulation-fibrinolysis system.
The major limitation of percutaneous coronary intervention (PCI) is restenosis. Restenosis is considered to be an overreaction of the natural healing process after traumatic balloon dilatation. An elaborate web of cellular and molecular responses, including the interaction of platelets, leukocytes, and the coagulation-fibrinolysis system, as well as the secretion of various growth factors and pro-inflammatory cytokines, contributes to neointimal hyperplasia and the development of restenosis. Moreover, platelet and neutrophil activation after stenting appears to be different from that after balloon angioplasty alone. Pharmacotherapy targeting the cell-to-cell interaction between platelets and neutrophils may potentially offer an effective treatment strategy against restenosis after PCI.
Lee
Michael S
MS
Cedars-Sinai Medical Center, UCLA School of Medicine, Cardiovascular Intervention Center, Los Angeles, California, USA. michaelslee@pol.net
David
Eric M
EM
Makkar
Raj R
RR
Wilentz
James R
JR
D015906:Angioplasty, Balloon, Coronary; D001777:Blood Coagulation; D001792:Blood Platelets / Q000502:physiology*; D023903:Coronary Restenosis / Q000473:pathology / Q000503:physiopathology*; D005342:Fibrinolysis; D006801:Humans; D007962:Leukocytes / Q000502:physiology*; D012008:Recurrence