Restenosis after femoropopliteal PTA and elective stent implantation: predictive value of monocyte counts.
OBJECTIVE
To investigate the association of baseline peripheral blood monocyte counts and restenosis after femoropopliteal percutaneous transluminal angioplasty (PTA) and PTA plus elective stent implantation.


METHODS
Three hundred thirty consecutive patients (170 men; median age 71 years, interquartile range 61-78) with peripheral artery disease underwent femoropopliteal PTA (n=258) or PTA plus elective stent implantation (n=72). Multivariate Cox regression analysis was used to determine the predictive value of baseline peripheral blood monocyte counts on the rate of restenosis (> or =50% luminal reduction) in follow-up.


RESULTS
Cumulative patency at 6 and 12 months was 55% and 39% after PTA and 70% and 41% after elective stenting, respectively (p=0.19). Pretreatment monocyte counts (in tertiles) were associated with restenosis after PTA (p=0.002) and stent implantation (p=0.02). Compared to patients with monocyte counts <0.3x10(9)/L (lower tertile, n=128), patients with monocytes from 0.3 to 0.4x10(9)/L (middle tertile, n=91) had a 1.8-fold increased adjusted risk for restenosis (95% CI 1.1 to 2.8, p=0.01). Patients with monocytes >0.4x10(9)/L (upper tertile, n=87) had a 2.3-fold increased adjusted risk (95% CI 1.4 to 3.5, p<0.0001).


CONCLUSIONS
Baseline monocyte counts were associated with restenosis after femoropopliteal PTA and elective stent implantation, suggesting that circulating monocytes play a pivotal role in the development of recurrent lumen narrowing.
Schillinger
Martin
M
Departments of Angiology, University of Vienna, Medical Faculty, Vienna, Austria. martin.schillinger@akh-wien.ac.at
Exner
Markus
M
Mlekusch
Wolfgang
W
Haumer
Markus
M
Sabeti
Schila
S
Ahmadi
Ramazanali
R
Schwarzinger
Ilse
I
Wagner
Oswald
O
Minar
Erich
E
D000368:Aged; D017130:Angioplasty; D001157:Arterial Occlusive Diseases / Q000097:blood* / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D005263:Femoral Artery / Q000601:surgery*; D005500:Follow-Up Studies; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D011150:Popliteal Artery / Q000601:surgery*; D011237:Predictive Value of Tests; D012008:Recurrence; D015607:Stents