title: Plasma N-epsilon-(carboxymethyl)lysine levels are associated with the extent of vessel injury after coronary arterial stenting.
abstract: OBJECTIVE
  In animal models, increased tissue receptor for advanced glycation end products and its ligands, including N-epsilon-(carboxymethyl)lysine (CML), are critically implicated in postprocedural intimal hyperplasia after balloon injury. In patients undergoing percutaneous coronary interventions with stenting, we investigated whether plasma levels of CML and the soluble form of receptor for advanced glycation end products (sRAGE) changed during poststenting follow-up.
  
  
  METHODS
  We studied 81 patients with coronary artery disease who underwent successful percutaneous coronary interventions. Plasma levels of CML and sRAGE were measured before intervention, and at 1 day and 180 days of follow-up.
  
  
  RESULTS
  CML levels increased significantly at day 1 after stenting and persisted at an elevated level at 180 days (P=0.013), whereas sRAGE levels increased significantly at 180 days (P=0.011). CML levels were significantly higher in multivessel-treated patients than in single-vessel-treated patients both at 1 day and 180 days of follow-up. In addition, CML values were positively associated with the extent of stent area at 1 day and 180 days of follow-up (r=0.278, P=0.022 and r=0.315, P=0.012, respectively). In logistic regression analysis, only the extent of stent area predicted adverse clinical events at 180-day follow-up (P=0.03, odds ratio=14.25, confidence interval=1.25-162.2).
  
  
  CONCLUSIONS
  This study supports the hypothesis that increased circulating levels of CML occurred in the presence of vascular injury. This persistent rise of CML could amplify an inflammatory phenomenon triggered by stent placement and thus contributes to coronary artery disease progression.
authors.affiliation: CNR, Institute of Clinical Physiology, Pisa, Massa, Italy. lapina@ifc.cnr.it
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Basta
authors.forename: Sergio
authors.initials: S
authors.lastname: Berti
authors.forename: Franca
authors.initials: F
authors.lastname: Cocci
authors.forename: Guido
authors.initials: G
authors.lastname: Lazzerini
authors.forename: Serena
authors.initials: S
authors.lastname: Parri
authors.forename: Angela
authors.initials: A
authors.lastname: Papa
authors.forename: Debora
authors.initials: D
authors.lastname: Battaglia
authors.forename: Valter
authors.initials: V
authors.lastname: Lubrano
authors.forename: Serena
authors.initials: S
authors.lastname: Del Turco
authors.forename: Marcello
authors.initials: M
authors.lastname: Ravani
authors.forename: Antonio
authors.initials: A
authors.lastname: Rizza
authors.forename: Raffaele
authors.initials: R
authors.lastname: De Caterina
authors.forename: Paolo
authors.initials: P
authors.lastname: Marraccini
authors.forename: Annamaria
authors.initials: A
authors.lastname: Mazzone
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D002097:C-Reactive Protein; D002404:Catheterization / Q000009:adverse effects; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008239:Lysine / Q000031:analogs & derivatives* / Q000097:blood; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic / Q000097:blood*; D015607:Stents / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000067759:Receptor for Advanced Glycation End Products; D011971:Receptors, Immunologic; C048496:N(6)-carboxymethyllysine; D002097:C-Reactive Protein; D008239:Lysine