AbstractBackgroundBy stimulating sympathetic afferents, repetitive myocardial ischemia induces a state of increased sympathetic tone.HypothesisRemoving the ischemic trigger by revascularization using percutaneous coronary intervention (PCI) might thus reduce central sympathetic activity in symptomatically stable angina patients.MethodsA total of 20 patients with stable angina ≥ New York Heart Association (NYHA) class II with persistent symptoms despite maximal pharmacological therapy and a clinical indication for PCI, were included in our study. Sympathetic nervous system activity was measured before and 1 month after PCI by a combination of techniques: direct muscle sympathetic nerve activity (MSNA), neurochemical (plasma catecholamine levels), and heart rate variability (HRV).ResultsAll patients completed the study. After PCI there was a significant reduction in MSNA (pre‐PCI 72 ± 4 to post‐PCI 53 ± 4 burst/100 beats, P < .05) and low frequency/high frequency (LF/HF) ratio (3.7 ± 0.6 vs 2.4 ± 0.4, P < .05) consistent with a decline in sympathetic activity. Plasma norepinephrine levels were reduced after PCI, but this difference did not reach statistical significance (1.84 ± 0.17 vs 1.73 ± 0.13 nmol/L, P = not significant).ConclusionCoronary revascularization by PCI reduces sympathetic activity in patients with established myocardial ischemia. Copyright © 2010 Wiley Periodicals, Inc.