Pre-intervention eosinophil cationic protein serum levels predict clinical outcomes following implantation of drug-eluting stents.
OBJECTIVE
Eosinophils have been identified in post-mortem studies as important players of both restenosis and thrombosis after drug-eluting stent (DES) implantation. We aimed at assessing the association between baseline levels of eosinophil cationic protein (ECP), a marker of eosinophil activation, and recurrence of clinical events in a consecutive series of patients who underwent DES implantation.


RESULTS
Two hundred patients (age 63 +/- 10.4, males 75%) undergoing implantation of first-generation DES (Taxus or Cypher stents) were enrolled. We measured serum levels of ECP and total IgE by enzyme-linked immunosorbent assay and of C-reactive protein by high-sensitivity nephelometry prior to percutaneous coronary intervention. A clinical follow-up was planned 18 months after discharge. Major adverse cardiac events (MACEs), such as cardiac death, recurrent myocardial infarction, or clinically driven target lesion revascularization, were the endpoint of the study. Twenty-two patients (11%) had MACEs and showed higher serum levels of ECP compared with those without MACEs [30.5 (14.4-50) vs. 12.2 (4.4-31) microg/L, P = 0.004]. At simple Cox regression analysis, serum levels of ECP were a significant predictor of MACEs (hazard ratio 1.016, 95% confidence interval 1.003-1.03, P = 0.018).


CONCLUSIONS
This study shows for the first time an association between baseline ECP levels and the occurrence of MACEs in patients undergoing implantation of DES. Further studies are warranted to establish whether in this setting ECP is a risk marker or plays a contributory pathogenetic role.
Niccoli
Giampaolo
G
Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy. gniccoli73@hotmail.it
Schiavino
Domenico
D
Belloni
Flavia
F
Ferrante
Giuseppe
G
La Torre
Giuseppe
G
Conte
Micaela
M
Cosentino
Nicola
N
Montone
Rocco Antonio
RA
Sabato
Vito
V
Burzotta
Francesco
F
Trani
Carlo
C
Leone
Antonio Maria
AM
Porto
Italo
I
Pieroni
Maurizio
M
Patriarca
Giampiero
G
Crea
Filippo
F
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D015415:Biomarkers / Q000097:blood; D023903:Coronary Restenosis / Q000378:metabolism* / Q000628:therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D047150:Eosinophil Cationic Protein / Q000097:blood*; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies
D015415:Biomarkers; D007074:Immunoglobulin G; D047150:Eosinophil Cationic Protein; C479220:RNASE3 protein, human