title: Reduced systemic inflammatory response to implantation of sirolimus-eluting stents in patients with stable coronary artery disease.
abstract: Stent implantation causes significant injury to the vascular wall, resulting in inflammatory activation. Although sirolimus-eluting stents (SES) have anti-inflammatory properties, their effect on periprocedural systemic inflammatory response has not been sufficiently investigated. Eighty-one patients with stable coronary artery disease involving severe stenosis of one major epicardial coronary artery underwent coronary angioplasty with stent implantation and randomly received either SES or bare metal stents (BMS). Blood samples were taken 24h before, at 24h, 48 h and 1 month after the angioplasty and levels of high sensitive C-reactive protein (hsCRP), interleukin-6 (IL-6), interleukin-1 beta (IL-1 beta), and monocyte chemoattractant protein-1 (MCP-1) were determined. HsCRP after BMS implantation increased over 24h (p<0.001) and then remained steady, as did IL-6 and IL-1 beta similarly. In contrast, their levels in SES patients decreased to below baseline by the end of the month. MCP-1 levels increased by the end of 1 month (p<0.001) in the BMS group, whereas in SES they steadily decreased, becoming significantly lower than baseline from 48 h (p=0.015). In conclusion, patients with SES exhibit an attenuation of the postprocedural systemic inflammatory activation during a 1-month follow-up after stent implantation. This might partially explain the reduced restenosis rate associated with SES.
authors.affiliation: Cardiology Department, University Hospital of Heraklion, Heraklion, Crete, Greece.
authors.forename: George E
authors.initials: GE
authors.lastname: Kochiadakis
authors.forename: Maria E
authors.initials: ME
authors.lastname: Marketou
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Arfanakis
authors.forename: Katerina
authors.initials: K
authors.lastname: Sfiridaki
authors.forename: Emmanuel I
authors.initials: EI
authors.lastname: Skalidis
authors.forename: Nikos E
authors.initials: NE
authors.lastname: Igoumenidis
authors.forename: Michael I
authors.initials: MI
authors.lastname: Hamilos
authors.forename: Stavroula
authors.initials: S
authors.lastname: Kolyvaki
authors.forename: Gregory
authors.initials: G
authors.lastname: Chlouverakis
authors.forename: Ermioni
authors.initials: E
authors.lastname: Kantidaki
authors.forename: Elias
authors.initials: E
authors.lastname: Castanas
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: D000368:Aged; D002097:C-Reactive Protein / Q000187:drug effects; D018932:Chemokine CCL2 / Q000187:drug effects; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000276:immunology; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage* / Q000276:immunology; D007249:Inflammation / Q000188:drug therapy; D053583:Interleukin-1beta / Q000187:drug effects; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage* / Q000276:immunology
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D007166:Immunosuppressive Agents; D053583:Interleukin-1beta; D015850:Interleukin-6; D002097:C-Reactive Protein; D020123:Sirolimus