Coronary Artery Disease: Inflammatory Pathways and Interventions

Abstract

Coronary artery disease remains one of the major causes of morbidity and mortality worldwide. Inflammation plays a crucial role in all stages of this disease. It is involved in the development of initial atherosclerotic lesions, plaque- progression, rupture and erosion, and additionally, contributes to ischemia and reperfusion injury after acute myocardial infarction. Therapeutic strategies that target the detrimental effects of the inflammatory process could therefore optimize current treatment regimens in patients with coronary artery disease. Recent landmark studies have finally brought anti-inflammatory therapy from theory to practice for secondary prevention. The road to clinical implementation of therapies that target the acute effects of inflammation in myocardial infarction, however, remains one with many hurdles. With this thesis we aimed to contribute to the unravelment of detrimental inflammatory pathways in the wide spectrum of coronary artery disease and investigated the effects and mechanisms of action of anti-inflammatory therapies, like a selective NLRP3 inflammasome inhibitor and colchicine. Furthermore, we studied the efficacy of the coronary sinus reducer in patients with refractory angina.