Comparison of effects of drug-eluting stents versus bare metal stents on plasma C-reactive protein levels.
After coronary stenting, inflammatory mechanisms play a crucial role in the pathogenesis of neointimal proliferation and in-stent restenosis. Drug-eluting stents (DESs) have been shown to decrease in-stent restenosis in different studies. We compared plasma C-reactive protein (CRP) levels after DES implantation with levels after bare metal stent (BMS) implantation. We performed percutaneous coronary intervention with a single stent in 67 patients (54 men; 59 +/- 9 years of age; n = 21 in the BMS group, n = 46 in the DES group) who had stable angina. Plasma CRP levels were determined before intervention and at 48 hours, 72 hours, and 2 weeks after coronary stenting. There was no difference in clinical and angiographic baseline characteristics except that the DES group had more patients with diabetes (34.8% vs 9.5%, p = 0.04), smaller reference vessels (2.95 +/- 0.53 vs 3.29 +/- 0.53 mm, p = 0.02), and smaller stent diameters (3.0 +/- 0.4 mm vs 3.4 +/- 0.5 mm, p <0.01). Plasma CRP levels at 48 hours (13.4 +/- 14.7 vs 5.9 +/- 4.9 mg/L, p <0.01) and 72 hours (16.7 +/- 19.8 vs 5.4 +/- 3.9 mg/L, p <0.01) after stent implantation were significantly higher in the BMS than in the DES group. In conclusion, DESs showed significantly lower plasma CRP levels after coronary stenting compared with BMSs. This may reflect the potent effects of DESs on acute inflammatory reactions induced by coronary intervention.
Kim
Jong-Youn
JY
The Cardiology Division, Yonsei Cardiovascular Center and Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Republic of Korea.
Ko
Young-Guk
YG
Shim
Chi Young
CY
Park
Sungha
S
Hwang
Ki-Chul
KC
Choi
Donghoon
D
Jang
Yangsoo
Y
Chung
Namsik
N
Shim
Won-Heum
WH
Cho
Seung-Yun
SY
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation; D002097:C-Reactive Protein / Q000378:metabolism*; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy; D023903:Coronary Restenosis / Q000097:blood / Q000000981:diagnostic imaging; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use; D020123:Sirolimus / Q000627:therapeutic use; D015607:Stents; D016896:Treatment Outcome
D000972:Antineoplastic Agents, Phytogenic; D015415:Biomarkers; D020099:Coated Materials, Biocompatible; D007166:Immunosuppressive Agents; D002097:C-Reactive Protein; D017239:Paclitaxel; D020123:Sirolimus