title: 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.
abstract: 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.
authors.affiliation: Cardiology Department, Heraklion University Hospital, PO Box 1352, Heraklion 71110, 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
authors.initials: D
authors.lastname: Panutsopulos
authors.forename: Dimitris A
authors.initials: DA
authors.lastname: Arfanakis
authors.forename: Emmanuel I
authors.initials: EI
authors.lastname: Skalidis
authors.forename: Nikolaos E
authors.initials: NE
authors.lastname: Igoumenidis
authors.forename: Michael I
authors.initials: MI
authors.lastname: Hamilos
authors.forename: George
authors.initials: G
authors.lastname: Sourvinos
authors.forename: Gregory
authors.initials: G
authors.lastname: Chlouverakis
authors.forename: Demetrios
authors.initials: D
authors.lastname: Spandidos
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: 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*
chemical_list: D007166:Immunosuppressive Agents; D050257:Tubulin Modulators; D042461:Vascular Endothelial Growth Factor A; D020123:Sirolimus