title: The double-faced metabolic and inflammatory effects of standard drug therapy in patients after percutaneous treatment with drug-eluting stent.
abstract: OBJECTIVE
  The inflammatory responses after percutaneous coronary intervention (PCI) with drug-eluting stent (DES) remain poorly understood; therefore, this study aims to investigate the changes of metabolic parameters and systematic inflammatory status of circulating mononuclear cells (MNC) in patients after percutaneous treatment with DES implantation.
  
  
  RESULTS
  Twenty-seven patients with acute coronary syndrome who would undergo PCI with DES implantation were consecutively recruited and treated with standard drug therapy from the start of hospitalization. Metabolic parameters including total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein improved significantly after 12 weeks of standard medication, whereas the plasma levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), macrophage migration inhibitory factor (MIF), and matrix metalloproteinase-9 (MMP-9) increased (P=0.012, 0.035, 0.062 and 0.112, respectively, compared to the baseline). The NF-κB DNA binding activity in MNC increased significantly compared to the baseline (P=0.015), whereas IκB-β and PPAR-γ were significantly suppressed (P=0.046 and 0.002, respectively). There were strong correlations among the changes of metabolic parameters and the changes of proinflammatory factors; however, none of them is statistically significant.
  
  
  CONCLUSIONS
  Standard drug therapy can improve the metabolic parameters but fail to restrain the proinflammatory state after PCI with DES implantation. Longer term endpoint-based studies are still needed for further exploration of the relationship between inflammatory factors and clinical cardiovascular events in the era of DES.
authors.affiliation: Department of Cardiovascular Medicine, First Affiliated Hospital of Medical College, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
authors.forename: Yue
authors.initials: Y
authors.lastname: Wu
authors.forename: Weiping
authors.initials: W
authors.lastname: Zhang
authors.forename: Weimin
authors.initials: W
authors.lastname: Liu
authors.forename: Xiaozhen
authors.initials: X
authors.lastname: Zhuo
authors.forename: Zhao
authors.initials: Z
authors.lastname: Zhao
authors.forename: Zuyi
authors.initials: Z
authors.lastname: Yuan
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy*; D054855:Drug-Eluting Stents / Q000009:adverse effects; D005260:Female; D006801:Humans; D007249:Inflammation / Q000503:physiopathology*; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007963:Leukocytes, Mononuclear / Q000187:drug effects / Q000378:metabolism*; D050356:Lipid Metabolism / Q000187:drug effects; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D016328:NF-kappa B / Q000378:metabolism; D020123:Sirolimus / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome
chemical_list: D018836:Inflammation Mediators; D015850:Interleukin-6; D016328:NF-kappa B; D020780:Matrix Metalloproteinase 9; D020123:Sirolimus