title: Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries.
abstract: 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.
authors.affiliation: The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Science, Gwangju, Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Sang Rok
authors.initials: SR
authors.lastname: Lee
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.forename: Il Suk
authors.initials: IS
authors.lastname: Sohn
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.forename: Weon
authors.initials: W
authors.lastname: Kim
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.forename: Jung Chaee
authors.initials: JC
authors.lastname: Kang
mesh_terms: 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
chemical_list: D015415:Biomarkers