Comparison of the systemic levels of inflammatory markers after percutaneous coronary intervention with bare metal versus sirolimus-eluting stents.
BACKGROUND
Percutaneous coronary intervention (PCI) with bare metal stent (BMS) deployment causes plaque disruption and a rise in systemic levels of C-reactive protein (CRP), interleukin (IL)-6, and monocyte chemoattractant protein (MCP)-1. Our aim is to study whether PCI with sirolimus-eluting stent (SES) use attenuates this response.


METHODS
Patients with stable angina undergoing single-vessel PCI were enrolled in a randomized, open-label fashion into a BMS group or an SES group. Blood samples were drawn pre-PCI, 24 hours post-PCI, and 30 days post-PCI. Systemic concentrations of CRP, IL-6, and MCP-1 were measured at all time points.


RESULTS
In total, 41 patients were enrolled (21 in the BMS group and 20 in the SES group). The baseline plasma concentrations of all markers were comparable between groups. At 24 hours, the mean plasma CRP concentration in the SES group was 20.21 mg/dL versus 8.95 mg/dL in the BMS group (P = 0.15). The mean plasma IL-6 concentration at 24 hours was 25.41 pg/mL in the SES group versus 17.44 pg/mL in the BMS group (P = 0.17). The mean plasma MCP-1 concentration at 24 hours was 382.38 pg/mL in the SES group versus 329.04 pg/mL in the BMS group (P = 0.2). At 30 days, plasma concentrations of all three markers decreased to similar values between groups.


CONCLUSIONS
The use of SES did not inhibit the rise in systemic concentrations of CRP, IL-6, and MCP-1 at 24 hours or 30 days post-PCI, compared with BMS. Moreover, at 24 hours, there was a trend for higher systemic levels of all proinflammatory markers in the SES group compared with the BMS cohort.
Rebeiz
Abdallah G
AG
From the American University of Beirut Medical Center, Division of Cardiology, Beirut, Lebanon.
Zoghbi
Elie
E
Harb
Rami
R
Youhanna
Sonia
S
Skouri
Hadi N
HN
Dimassi
Adel
A
Abou-Nader
Gilbert
G
Nasrallah
Antoine
A
Sawaya
Jaber
J
Gharzuddine
Walid
W
Alam
Samir
S
D000368:Aged; D000787:Angina Pectoris / Q000097:blood* / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D002097:C-Reactive Protein / Q000032:analysis*; D018932:Chemokine CCL2 / Q000097:blood*; D023921:Coronary Stenosis / Q000097:blood / Q000628:therapy; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015850:Interleukin-6 / Q000097:blood*; D008297:Male; D008875:Middle Aged; D020123:Sirolimus / Q000008:administration & dosage; D015607:Stents
D018932:Chemokine CCL2; D007166:Immunosuppressive Agents; D015850:Interleukin-6; D002097:C-Reactive Protein; D020123:Sirolimus