Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries.
BACKGROUND
The mechanism of restenosis after stent implantation principally is neointimal hyperplasia. There is evidence that monocytes play a important role in in-stent restenosis (ISR) after stent implantation.


OBJECTIVE
This study assessed the relationship between preinterventional peak monocyte count and neointimal growth after successful stent implantation.


METHODS
We performed coronary stent implantation in 85 patients (85 de novo lesions). Peripheral blood sample was obtained in all patients every 12 h before coronary angiography for measurement of peripheral monocytes. All patients received angiographic and intravascular ultrasound (IVUS) follow-up at 6 months after stenting.


RESULTS
The preinterventional circulating monocyte count was significantly higher in the ISR group than that in the group without ISR (654 +/- 62/vs. 461 +/- 222/mm3, p < 0.001) and was significantly higher in the reintervention group than that in the no-reintervention group (660 +/- 72/ vs. 470 +/- 216/mm3, p< 0.001). The incidence of ISR and repeat intervention associated with preinterventional monocyte count was highest among the patients in the highest tertile, who were at a 2.64-fold increased risk of ISR and 3.22-fold increased risk of repeat intervention compared with the patients in the lowest tertile. A significant positive correlation was found between preinterventional peak monocyte count and preinterventional plaque and media cross-sectional area and follow-up neointima area (r = 0.311, p = 0.007, r = 0.465, p < 0.001, respectively). The neointima area associated with preinterventional monocyte count was largest among the patients in the highest tertile, that is, 2-fold larger than that of the patients in the lowest tertile (p < 0.001) and 1.44-fold larger than that of the patients in the middle tertile (p = 0.001).


CONCLUSIONS
Our results suggest that circulating preinterventional monocytes play a principal role in the process of in-stent neointimal growth after successful stent implantation.
Hong
Young Joon
YJ
The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Science, Gwangju, Korea.
Jeong
Myung Ho
MH
Lim
Sang Yup
SY
Lee
Sang Rok
SR
Kim
Kye Hun
KH
Sohn
Il Suk
IS
Park
Hyung Wook
HW
Kim
Ju Han
JH
Kim
Weon
W
Ahn
Youngkeun
Y
Cho
Jeong Gwan
JG
Park
Jong Chun
JC
Kang
Jung Chaee
JC
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000097:blood; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery*; D023903:Coronary Restenosis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006965:Hyperplasia / Q000473:pathology / Q000601:surgery; D015994:Incidence; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D011300:Preoperative Care; D012086:Reoperation; D012307:Risk Factors; D015607:Stents / Q000009:adverse effects; D016896:Treatment Outcome; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology* / Q000601:surgery*; D018084:Ultrasonography, Interventional
D015415:Biomarkers