title: Release of TNF-alpha during stent implantation into saphenous vein aortocoronary bypass grafts and its relation to plaque extrusion and restenosis.
abstract: The reduction in plaque volume during stent implantation is associated with the release of particulate debris and plaque-derived soluble substances. We studied the potential release of the proinflammatory cytokine TNF-alpha into the coronary circulation and whether such release is related to the reduction in plaque volume and, possibly, a predictor for restenosis. In 18 male patients (n = 24 stents) with severe stenosis in a saphenous vein aortocoronary bypass graft (SVG), we used a distal balloon occlusion-aspiration device during stent implantation. The aspirate TNF-alpha levels were determined before and after stent implantation and related to the angiographic and intravascular ultrasound-assessed severity of stenosis and restenosis. We found that TNF-alpha is, indeed, released into the aspirate of stented SVG (9 +/- 1 and 28 +/- 3 pg/ml before and after stent implantation, respectively, P < 0.0001) and that such release is related to the reduction in plaque volume (r = 0.88, P < 0.0001) and associated with restenosis after 5 mo (r = 0.71, P = 0.001). The periprocedural release of plaque-derived TNF-alpha possibly represents the amount and activity of the atherosclerotic process and might be a predictor for restenosis.
authors.affiliation: Department of Cardiology, University of Essen Medical School, Hufelandstrasse 55, 45147 Essen, Germany.
authors.forename: Dirk
authors.initials: D
authors.lastname: Böse
authors.forename: Kirsten
authors.initials: K
authors.lastname: Leineweber
authors.forename: Thomas
authors.initials: T
authors.lastname: Konorza
authors.forename: Andreas
authors.initials: A
authors.lastname: Zahn
authors.forename: Martina
authors.initials: M
authors.lastname: Bröcker-Preuss
authors.forename: Klaus
authors.initials: K
authors.lastname: Mann
authors.forename: Michael
authors.initials: M
authors.lastname: Haude
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
authors.forename: Gerd
authors.initials: G
authors.lastname: Heusch
mesh_terms: D050197:Atherosclerosis / Q000378:metabolism* / Q000601:surgery*; D001807:Blood Vessel Prosthesis / Q000009:adverse effects; D001026:Coronary Artery Bypass / Q000009:adverse effects*; D006083:Graft Occlusion, Vascular / Q000209:etiology* / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012501:Saphenous Vein / Q000378:metabolism* / Q000637:transplantation; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism*
chemical_list: D014409:Tumor Necrosis Factor-alpha