Vascular endothelial growth factor protein levels and gene expression in peripheral monocytes after stenting: a randomized comparative study of sirolimus: eluting and bare metal stents.
OBJECTIVE
Although previous studies have indicated that vascular endothelial growth factor (VEGF) plays an important role in the vascular-healing process after stent implantation, its effect on in-stent restenosis is unclear. We assessed VEGF serum protein levels and gene expression in peripheral monocytes in relation to in-stent restenosis after implantation of sirolimus-eluting (SES) and bare metal stents (BMS) in a non-blinded, randomized study.


RESULTS
Forty-two patients (28 men, age 62 +/- 11 years) with stable angina, who underwent elective single-vessel percutaneous coronary intervention, were randomized to SES (n = 21) or BMS (n = 21) implantation. VEGF protein levels in the BMS group showed an increasing trend (P = 0.083), whereas in the SES group they decreased significantly (P = 0.002). BMS induced up-regulation of VEGF mRNA levels, whereas for SES down-regulation was observed. There was no correlation between serum levels and late luminal loss. A significant correlation was found between VEGF gene expression and late luminal loss in both groups (BMS: r = 0.98, P < 0.001; SES: r = 0.65, P = 0.002).


CONCLUSIONS
SES, in comparison with BMS, results in lower VEGF protein levels and gene expression in peripheral monocytes. The latter shows a positive relationship with in-stent late-luminal loss, suggesting an essential role in the reduced in-stent restenosis seen in SES.
Kochiadakis
George E
GE
Cardiology Department, Heraklion University Hospital, PO Box 1352, Heraklion 71110, Crete, Greece.
Marketou
Maria E
ME
Panutsopulos
Dimitris
D
Arfanakis
Dimitris A
DA
Skalidis
Emmanuel I
EI
Igoumenidis
Nikolaos E
NE
Hamilos
Michael I
MI
Sourvinos
George
G
Chlouverakis
Gregory
G
Spandidos
Demetrios
D
Vardas
Panos E
PE
D023903:Coronary Restenosis / Q000097:blood*; D004305:Dose-Response Relationship, Drug; D015536:Down-Regulation; D005260:Female; D015870:Gene Expression; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D020123:Sirolimus / Q000008:administration & dosage* / Q000494:pharmacology; D015607:Stents; D050257:Tubulin Modulators / Q000008:administration & dosage*; D042461:Vascular Endothelial Growth Factor A / Q000235:genetics / Q000378:metabolism*
D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D042461:Vascular Endothelial Growth Factor A; D020123:Sirolimus