Inflammatory response after dexamethasone eluting coronary stent implantation.
C-reactive protein (CRP) elevation after coronary stent implantation is a predictor for recurrence. We prospectively evaluated the inflammatory response after dexamethasone eluting stent implantation in a native coronary artery by serial measurement of plasma level C-reactive protein.


METHODS
We investigated patients undergoing primary successful implantation of a single dexamethasone stent (Dexamet, Abbott Vascular Devices, Redwood City, CA, USA) in a native coronary artery. We analyzed plasma concentrations of CRP by immunoturbidimetric assay before stent implantation and 12, 24, 48 and 72 hours after the procedure. Patients on anti-inflammatory drugs or with evidences of inflammatory conditions were excluded.


RESULTS
Seventeen patients (mean age 62+/-9 years, 12 males) were enrolled. The presentation was unstable angina in 13 patients and stable angina in 4 patients. Eighteen stents were implanted as follows: 16 type B lesions (88%), 1 type C lesions (6%) and 1 type A lesion (6%), located in LM in 2 patients (11%), LAD in 8 (44%), LCX/OM in 7 (39%), and RCA in 1 patient (6%). The mean CRP increased from 5.6+/-2.2 mg/l at baseline to a maximum of 6.7+/-2.1 mg/l and than decreased to 5.0+/-1.2 mg/l at 72 hours. At 72 hours plasma concentration of CRP was lower than baseline in 11 patients (65%) and higher in 6 (35%).


CONCLUSIONS
Inflammatory response to dexamethasone stent implantation in a native coronary artery is low and peaks at 24 hours. At 72 hours after stent implantation, mean CRP decreased comparing with baseline, CRP becoming lower in 65% patients. Using the stent itself as a platform for drug delivery may be an opportunity to modulate the inflammatory response to coronary stent implantation.
Mut-Vitcu
B
B
Institute of Cardiovascular Medicine, Timişoara, Romania. office@cardiologie.ro
Drăgulescu
S I
SI
Drăgulescu
Andreea
A
El Kahlout
A
A
Coroban
Adriana
A
Maximov
Daniela
D
Slovenski
M
M
D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000378:metabolism*; D003327:Coronary Disease / Q000628:therapy*; D003907:Dexamethasone / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D015607:Stents; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003907:Dexamethasone; D002097:C-Reactive Protein