Effects of carbon-coated coronary stents on the markers of inflammation, thrombin generation and platelet and endothelial activation.
BACKGROUND
The effects of stent carbon coating on the activation of inflammatory and endothelial cells and of coagulation were assessed in patients undergoing coronary artery stent implantation.


METHODS
Forty-four consecutive patients with stable angina and an isolated significant stenosis in a native coronary vessel undergoing stent implantation were randomized to a carbon-coated stent (Carbostent, n = 23) or an uncoated stent with a similar design (Multilink, n = 21). The markers of inflammation, of hemostasis and of platelet and endothelial activation were determined before and 6, 24, 48 and 72 hours after the procedure.


RESULTS
Procedural success was achieved in all cases and no patient presented with major in-hospital adverse events. In both the Carbostent and Multilink groups, the median (interquartile range) plasma levels of C-reactive protein significantly increased after the procedure (p < 0.001 and p = 0.002 vs baseline levels, respectively), reaching a peak at 48 hours, without any difference between groups (p = 0.76). Similarly, in both groups the plasma levels of fibrinogen, thrombin-antithrombin III complexes, prothrombin fragments F1 + 2, plasminogen activator inhibitor-1, soluble E-selectin, soluble P-selectin and von Willebrand factor significantly increased after the procedure (all p < 0.05 vs baseline values), without any difference between groups (all p = NS).


CONCLUSIONS
This study confirms that the markers of inflammation, of endothelial and platelet activation and of thrombin generation significantly increase after successful coronary artery stent implantation. More importantly, it demonstrates that carbon coating does not modify the biologic response of the vessel wall to stent implantation.
Tomai
Fabrizio
F
Division of Cardiac Surgery, Tor Vergata University, European Hospital, Via Portuense, 700, 00149 Roma. f.tomai@tiscali.it
Ghini
Anna S
AS
Ferri
Claudio
C
Desideri
Giovambattista
G
Versaci
Francesco
F
Gaspardone
Achille
A
Altamura
Luca
L
Magliano
Giulia
G
Crea
Filippo
F
Chiariello
Luigi
L
D000368:Aged; D000787:Angina Pectoris / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D015415:Biomarkers / Q000032:analysis; D002244:Carbon; D020099:Coated Materials, Biocompatible; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D004869:Equipment Safety; D005260:Female; D006801:Humans; D018836:Inflammation Mediators / Q000032:analysis*; D008297:Male; D008875:Middle Aged; D015539:Platelet Activation / Q000502:physiology*; D011336:Probability; D012016:Reference Values; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D015607:Stents; D013917:Thrombin / Q000032:analysis / Q000378:metabolism*; D016896:Treatment Outcome
D015415:Biomarkers; D020099:Coated Materials, Biocompatible; D018836:Inflammation Mediators; D002244:Carbon; D013917:Thrombin