Endocannabinoid system: A new player in the percutaneous and surgical treatment of coronary artery disease?

The endocannabinoid system contributes to the control of many physiological and pathological aspects of the human body. Its importance in cardiovascular disease has been increasingly acknowledged in the last years and now the endocannabinoid system is considered one of the major endogenous contributors to its effects. Increased endocannabinoid plasma levels of anandamide (AEA) and 2-arachidonoylglycerol (2-AG) have been shown to be associated with coronary microcirculatory dysfunction and early abnormal functional stage of coronary artery disease (CAD) almost 10 years ago [ 1 ], and the increase in AEA and 2-AG levels have been considered an endogenous cardiovascular risk factor especially in obese patients [ 1 , 2 ]. Moreover, endocannabinoids are markedly released following acute coronary syndrome, and the well-known accumulation of neutrophils and monocytes in the ischemic myocardium might also be stimulated from changes in endocannabinoid gradients leading to myeloid cell recruitment from the bone marrow [