Preprocedural inflammatory markers do not predict restenosis after successful coronary stenting.
BACKGROUND
Levels of C-reactive protein (CRP), serum amyloid A protein (SAA), and interleukin-6 (IL-6) can predict coronary restenosis following angioplasty and stent deployment in patients with unstable angina. We investigated whether measurement of periprocedural inflammatory markers predicted the angiographic outcome at 6 months in stable angina patients undergoing coronary stenting.


METHODS
We prospectively studied 182 patients; 152 patients underwent elective and successful stenting procedure for de novo lesions in native and nongrafted coronary arteries and 30 individuals in the control group underwent diagnostic angiography alone. CRP, SAA, and IL-6 were determined by high-sensitivity immunoassays.


RESULTS
At 6 months, quantitative computer-assisted angiographic analysis in 133 patients with stents showed a binary restenosis rate of 33.8%. Statins were being taken by 80% of the patients. There were no significant differences between the pre- or postprocedure values of CRP, SAA, or IL-6 in patients with or without in-stent restenosis.


CONCLUSIONS
Preprocedural inflammatory markers in stable angina subjects undergoing coronary artery stent deployment did not correlate with the development of in-stent restenosis. Differences in pathobiology between stable and unstable coronary syndromes, the widespread use of statins with anti-inflammatory activity in our cohort of patients, along with different mechanisms underlying the early angiographic appearances of restenosis as compared to clinical end points, most likely explain our findings.
Gomma
A H
AH
Cardiology Department, National Heart and Lung Institute and Royal Brompton Hospital, London, United Kingdom. a.gomma@doctors.org.uk
Hirschfield
G M
GM
Gallimore
J R
JR
Lowe
G D O
GD
Pepys
M B
MB
Fox
K M
KM
D000787:Angina Pectoris / Q000453:epidemiology; D015415:Biomarkers / Q000032:analysis; D002097:C-Reactive Protein / Q000032:analysis*; D015897:Comorbidity; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy*; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000685:Serum Amyloid A Protein / Q000032:analysis*; D015607:Stents
D015415:Biomarkers; D015850:Interleukin-6; D000685:Serum Amyloid A Protein; D002097:C-Reactive Protein