[Relationship between plasma C-reactive protein level and neointimal hyperplasia volume in patients with zotarolimus-eluting stents. Volumetric analysis by three-dimensional intracoronary ultrasound].
OBJECTIVE
C-reactive protein (CRP) is an inflammatory marker that predicts cardiac events in patients with coronary syndromes. However, data on the relationship between the CRP level and in-stent restenosis are contradictory. The objective of this study was to investigate the relationship between the basal CRP level and the neointimal hyperplasia volume measured by intracoronary ultrasound 4 months after implantation of a zotarolimus-eluting stent.


METHODS
The study included 40 consecutive patients who underwent zotarolimus-eluting stent implantation. Patients were divided into quartiles according to their preprocedural CRP level. Intracoronary ultrasound was performed after stent implantation and at 4 months, and the neointimal hyperplasia volume was determined using Simpson's rule. Correlation and linear regression analyses were used to evaluate the relationships between variables. Multivariate analysis was used to identify variables that were independently related to neointimal hyperplasia volume.


RESULTS
The patients' mean age was 58 (8) years, 55% were male, and 40% had diabetes mellitus. There was no difference in baseline characteristics between the quartiles. The hyperplasia volumes were 4.8 (4.2) microl and 15.8 (10.0) microl in the first and fourth quartiles, respectively (P< .001). There was a significant positive correlation between the CRP level and neointimal hyperplasia volume (r = 0.64, P=.0001). The CRP level, the postimplantation lumen volume, and the final deployment pressure were all independent predictors of neointimal hyperplasia.


CONCLUSIONS
In this study, an independent correlation was observed between the CRP level before zotarolimus-eluting stent implantation and the neointimal hyperplasia volume at 4-month follow-up.
Lasave
Leandro I
LI
Servicio de Hemodinámica y Cardiología Intervencionista, Instituto Dante Pazzanese de Cardiología, São Paulo, Brasil.
Abizaid
Alexandre A C
AA
Paiva e Maia
Julio
J
de Ribamar Costa
José
J
Feres
Fausto
F
Mattos
Luiz A
LA
Abizaid
Andrea S
AS
Siqueira
Dimytri A
DA
Tanajura
Luiz F
LF
Staico
Rodolfo
R
Beraldo de Andrade
Pedro
P
Braga
Sérgio N
SN
Sousa
Amanda G M R
AG
Sousa
J Eduardo
JE
D002097:C-Reactive Protein / Q000032:analysis*; D003331:Coronary Vessels / Q000000981:diagnostic imaging* / Q000473:pathology*; D016503:Drug Delivery Systems; D005260:Female; D006801:Humans; D006965:Hyperplasia; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives*; D015607:Stents; D017539:Tunica Intima / Q000473:pathology*; D018084:Ultrasonography, Interventional
D002097:C-Reactive Protein; C489443:zotarolimus; D020123:Sirolimus