Early elevation of interleukin-1beta and interleukin-6 levels after bare or drug-eluting stent implantation in patients with stable angina.
BACKGROUND
Drug-eluting stent (DES) implantation represents an important innovation in the treatment of coronary artery disease. However, inflammatory-related complications, including subacute thrombosis and in-stent restenosis, are still important limitations to percutaneous coronary intervention (PCI). The aim of this study was to compare early local release of interleukin 1beta (IL-1beta) and IL-6 proinflammatory cytokines after elective placement of either bare metal stents or DES.


METHODS
IL-1beta and IL-6 levels were assayed in plasma obtained from the coronary sinus both before and 20 min after stent implantation in 59 patients with stable angina, who were randomly assigned to receive bare, paclitaxel-, or sirolimus-eluting stents during elective PCI.


RESULTS
We found that IL-1beta and IL-6 levels were significantly increased in the coronary sinus of patients receiving either bare, paclitaxel- or sirolimus-eluting stents 20 min after stent implantation as compared with basal concentrations. The variation in the level of both cytokines was comparable among the three study groups.


CONCLUSIONS
A local release of proinflammatory cytokines occurs shortly after coronary stent placement, including DES, which is possibly related to plaque rupture and/or endothelium traumatism following the stenting procedure. This suggests that precocious anti-inflammatory treatment could be of benefit to further improve the PCI clinical outcome.
Sardella
Gennaro
G
Dipartimento di Scienze Cardiovascolari e Respiratorie, Università La Sapienza, Viale del Policlinico 155, 00161, Rome, Italy. rino.sardella@uniroma1.it
Mariani
Paola
P
D'Alessandro
Mariadomenica
M
De Luca
Leonardo
L
Pierro
Marianna
M
Mancone
Massimo
M
Porretta
Alessandro
A
Accapezzato
Daniele
D
Fedele
Francesco
F
Paroli
Marino
M
D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007375:Interleukin-1 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents
D007166:Immunosuppressive Agents; D007375:Interleukin-1; D015850:Interleukin-6; D017239:Paclitaxel; D020123:Sirolimus