Pathophysiology and outcomes of endothelium function in coronary microvascular diseases: a systematic review of randomized controlled trials and multicenter study

Avtaar Singh, S. S. and Nappi, F. (2022) Pathophysiology and outcomes of endothelium function in coronary microvascular diseases: a systematic review of randomized controlled trials and multicenter study. Biomedicines, 10(12), 3010. (doi: 10.3390/biomedicines10123010) (PMID:36551766) (PMCID:PMC9775403)

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Background: Coronary macrovascular disease is a concept that has been well-studied within the literature and has long been the subject of debates surrounding coronary artery bypass grafting (CABG) vs. Percutaneous Coronary Intervention (PCI). ISCHEMIA trial reported no statistical difference in the primary clinical endpoint between initial invasive management and initial conservative management, while in the ORBITA trial PCI did not improve angina frequency score significantly more than placebo, albeit PCI resulted in more patient-reported freedom from angina than placebo. However, these results did not prove the superiority of the PCI against OMT, therefore do not indicate the benefit of PCI vs. the OMT. Please rephrase the sentence. We reviewed the role of different factors responsible for endothelial dysfunction from recent randomized clinical trials (RCTs) and multicentre studies. Methods: A detailed search strategy was performed using a dataset that has previously been published. Data of pooled analysis include research articles (human and animal models), CABG, and PCI randomized controlled trials (RCTs). Details of the search strategy and the methods used for data pooling have been published previously and registered with Open-Source Framework. Results: The roles of nitric oxide (NO), endothelium-derived contracting factors (EDCFs), and vasodilator prostaglandins (e.g., prostacyclin), as well as endothelium-dependent hyperpolarization (EDH) factors, are crucial for the maintenance of vasomotor tone within the coronary vasculature. These homeostatic mechanisms are affected by sheer forces and other several factors that are currently being studied, such as vaping. The role of intracoronary testing is crucial when determining the effects of therapeutic medications with further studies on the horizon. Conclusion: The true impact of coronary microvascular dysfunction (CMD) is perhaps underappreciated, which supports the role of medical therapy in determining outcomes. Ongoing trials are underway to further investigate the role of therapeutic agents in secondary prevention.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Singh, Mr Sanjeet
Creator Roles:
Avtaar Singh, S. S.Methodology, Software, Validation, Formal analysis, Data curation, Writing – review and editing, Visualization, Supervision
Authors: Avtaar Singh, S. S., and Nappi, F.
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Journal Name:Biomedicines
ISSN (Online):2227-9059
Published Online:23 November 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in Biomedicines 10(12): 3010
Publisher Policy:Reproduced under a Creative Commons License

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