Regression of coronary atherosclerosis: Current evidence and future perspectives

Koskinas, Konstantinos C.; Windecker, Stephan; Räber, Lorenz

doi:10.1016/j.tcm.2015.05.004

Cited by 24 publications

(17 citation statements)

References 80 publications

(110 reference statements)

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“…However, although clearly effective for inhibiting atheroma progression, statins do not effectively reverse arterial disease. [18] Furthermore, there are several side effects associated with statin use, such as muscle pain and injury, [19] liver damage, [19] increased blood sugar and type 2 diabetes, [20] and an increased risk of hemorrhage. [21] …”

Section: Coronary Artery Disease and Common Treatmentsmentioning

confidence: 99%

Biodegradable Metals for Cardiovascular Stents: from Clinical Concerns to Recent Zn‐Alloys

Bowen

Shearier

Zhao

et al. 2016

Adv Healthcare Materials

393

244

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Metallic stents are commonly used to promote revascularization and maintain patency of plaqued or damaged arteries following balloon angioplasty. To mitigate the long-term side effects associated with corrosion-resistant stents (i.e. chronic inflammation and late stage thrombosis), a new generation of so-called “bioabsorbable” stents is currently being developed. The bioabsorbable coronary stents will corrode and be absorbed by the artery after completing their task as vascular scaffolding. Research spanning the last two decades has focused on biodegradable polymeric, iron-based, and magnesium-based stent materials. The inherent mechanical and surface properties of metals make them more attractive stent material candidates than their polymeric counterparts. Unfortunately, iron produces a voluminous, retained oxide product in the arterial wall, whereas magnesium and its alloys corrode too rapidly. A third class of metallic bioabsorbable materials that are based on zinc has been introduced in the last few years. As summarized in this contribution, this new zinc-based class of materials demonstrates the potential for an absorbable metallic stent with the mechanical and biodegradation characteristics required for optimal stent performance. They appear to be free of flaws that limit the application of iron- and magnesium-based alloys, and polymers. This review compares bioabsorbable materials and summarizes progress towards bioabsorbable stents. It emphasizes on current understanding of physiological and biological benefits of zinc and its biocompatibility. Finally, the review provides an outlook on challenges in designing zinc-based stents of optimal mechanical properties and biodegradation rate.

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Section: Coronary Artery Disease and Common Treatmentsmentioning

confidence: 99%

Biodegradable Metals for Cardiovascular Stents: from Clinical Concerns to Recent Zn‐Alloys

Bowen

Shearier

Zhao

et al. 2016

Adv Healthcare Materials

393

244

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“…In recent years, primarily in laboratory findings on the action and biological effects of statins, there has been intense discussion about the possibility that many of the beneficial effects of statins, beyond the reduction of cholesterol, are due to other types of actions described as pleiotropic [21]. …”

Section: Pleiotropic Effects Of Statinsmentioning

confidence: 99%

“…Some of the pleiotropic effects of statins are improving the function of vascular endothelial cells, enhancing the stability of atherosclerotic plaque, reducing oxidative stress and inflammation, and causing extrahepatic effects on the immune system, central nervous system, and bones [21]. …”

Section: Pleiotropic Effects Of Statinsmentioning

confidence: 99%

The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature

Diamantis

Kyriakos

Quiles-Sánchez

et al. 2017

CCR

173

108

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Background:Statins have long been used for the protection against coronary artery disease (CAD). Their beneficial effect apart from cholesterol reduction lies in their pleiotropic properties. Emerging evidence from laboratory studies and clinical trials as well have pointed out the pivotal role of inflammation on the initiation and exacerbation of atherosclerosis; a major cause of CAD. Inflam-mation markers such as high sensitivity C-reactive protein and adhesion molecules are shown to in-crease in CAD patients and are used as prognostic tools. It is well known that statins can actually re-duce the circulating levels of these agents slowing therefore the inflammatory process; interestingly not all types have the same outcome.Conclusion:The anti-inflammatory effect of statins on the formation of atherosclerotic plaque and the function of endothelial cells is thus of particular importance as these agents can actually ameliorate CAD prognosis

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“…Medical therapy aiming at the stabilization and possibly the reversal of atherosclerosis in patients with stable coronary artery disease (CAD) has steadily progressed over the past 20 years [1][2][3][4] . However, patients with CAD who remain symptomatic despite optimal anti-anginal therapy or with limited life expectancy due to multi-vessel CAD (mCAD) are candidates for coronary artery revascularization (CAR) [5,6] .…”

Section: Introductionmentioning

confidence: 99%

Respite for hybrid coronary revascularization

Gacad¹,

Singh²,

Motwani³

et al. 2019

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Hybrid coronary revascularization incorporates a surgical anastomosis of the left internal mammary artery to the left anterior descending coronary artery through a thoracotomy and percutaneous implantation of drug eluting stents in diseased non-left anterior descending coronary arteries. Hybrid coronary artery revascularization can be performed as a 1-stage procedure in a hybrid operating room or as a tightly scheduled 2-stage procedure. Hybrid coronary artery revascularization is seldom the selected modality for coronary revascularization due to the lack of a hybrid operating room in many hospitals, the recommended thoracotomy approach for bypass, or the rigid schedule of surgical and endovascular revascularization. A 2-stage approach, using a sternotomy as compared to standard thoracotomy, and a flexible schedule between surgical and endovascular procedures may facilitate the adoption of hybrid coronary revascularization with noncomplex multi-vessel stable coronary artery disease.

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Regression of coronary atherosclerosis: Current evidence and future perspectives

Cited by 24 publications

References 80 publications

Biodegradable Metals for Cardiovascular Stents: from Clinical Concerns to Recent Zn‐Alloys

Biodegradable Metals for Cardiovascular Stents: from Clinical Concerns to Recent Zn‐Alloys

The Anti-Inflammatory Effects of Statins on Coronary Artery Disease: An Updated Review of the Literature

Respite for hybrid coronary revascularization

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