Comparison of inflammatory markers and angiographic outcomes after implantation of sirolimus and paclitaxel-eluting stents.
OBJECTIVE
We compared the degree of systemic inflammation and its relation to the angiographic outcomes after drug-eluting stent (DES) implantations.


METHODS
We implanted a single DES in 79 stable angina patients (50 men; 60.4 (9.5) years of age; sirolimus-eluting stent (SES), n = 38; paclitaxel-eluting stent (PES), n = 41). The high-sensitivity C-reactive protein (hs-CRP) and interleukin 6 (IL-6) levels were determined before and at 24 hours, 72 hours, and 4 weeks after the percutaneous coronary intervention (PCI). An angiography and intravascular ultrasound (IVUS) were performed.


RESULTS
The hs-CRP and IL-6 levels at baseline did not differ between the two groups. The hs-CRP increased significantly from baseline at 24 hours and 72 hours after the PCI in both groups and there was a significant increase in the IL-6 level at 24 hours after the PCI in both groups. However, there was no significant difference between the two groups in any of the hs-CRP or IL-6 measurements. At follow-up, the late lumen loss was significantly higher in the PES group than in the SES group (0.57 (0.56) mm vs 0.28 (0.58) mm, respectively, p = 0.020). The neointimal hyperplasia (NIH) volume in the PES group was significantly higher than that in the SES group (23.1 (22.7) vs 3.8 (7.1) mm(3), respectively, p = 0.000). The percentage luminal volume reduction was higher in the PES group than in the SES group (18.9 vs 3.9%, p = 0.002). The absolute values or change in the inflammatory markers did not correlate with the NIH or stent volume reduction.


CONCLUSIONS
Our study showed that the benefits obtained from the SES, which reduce neointimal proliferation, are not probably mediated by the attenuation of the systemic inflammatory markers hs-CRP or IL-6.
Kang
W C
WC
Division of Cardiology, Gil Medical Center, Gachon University of Medicine and Science, Namdong-Gu, Incheon, Korea. kangwch@gilhospital.com
Ahn
T H
TH
Moon
C I
CI
Han
S H
SH
Shin
E K
EK
Kim
J-S
JS
Ko
Y-G
YG
Choi
D
D
Jang
Y
Y
Kim
B-K
BK
Oh
S J
SJ
Jeon
D W
DW
Yang
J-Y
JY
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000097:blood / Q000517:prevention & control; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000627:therapeutic use*; D011379:Prognosis; D011446:Prospective Studies; D020123:Sirolimus / Q000627:therapeutic use*; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D050257:Tubulin Modulators / Q000627:therapeutic use; D014463:Ultrasonography
D015415:Biomarkers; D018836:Inflammation Mediators; D015850:Interleukin-6; D050257:Tubulin Modulators; D002097:C-Reactive Protein; D017239:Paclitaxel; D020123:Sirolimus