Key result
Inflammation, endothelial dysfunction, and neoatherosclerosis drive post-stent restenosis and recurrent adverse cardiovascular events.
Why the study?
The pathogenetic and pathophysiological processes leading to stent restenosis and recurrent cardiovascular events in coronary heart disease patients require comprehensive understanding.
This review summarizes the pathogenetic mechanisms, particularly chronic inflammation and neointimal hyperplasia, driving stent restenosis after percutaneous coronary intervention.
Stent restenosis is the most unfavorable complication of interventional treatment for coronary heart disease. We already know from various literature sources that the causes for stent restenosis in patients are both mechanical damage (partial opening, stent breakage, extended stented area, calcification, incomplete stent coverage of atherosclerotic plaque, weak radial stiffness of the stent metal frame, lack of stent drug coating), and the neointimal hyperplasia formation which is closely related to the de novo atherosclerosis development, being a predictor of the recurrent cardiovascular event. Considering this event, it is necessary to understand all the pathogenetic and pathophysiological processes of atherosclerosis. This review aims to comprehensively highlight the main issues of pathogenesis and the development of stent restenosis in the coronary artery after percutaneous transluminal coronary angioplasty. The review is based on relevant publications found by a selective search of PubMed, Google Scholar, Scopus, Web of Science, and eLibrary, including works published within the last 20 years. The influence of various factors of the pathogenetic process on the risk of stent restenosis has been demonstrated.
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Starodubtseva et al. (2023) conducted a review in Coronary heart disease and in-stent restenosis. Percutaneous coronary intervention and stenting was evaluated. Chronic inflammation, endothelial dysfunction, and neoatherosclerosis play a significant role in the pathogenesis of in-stent restenosis and repeated adverse cardiovascular events after stenting.
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