title: Comparison of inflammatory markers for the prediction of neointimal hyperplasia after drug-eluting stent implantation.
abstract: BACKGROUND
  We compared the relationship between inflammatory markers and neointimal hyperplasia (NIH) after drug-eluting stent (DES) implantation.
  
  
  METHODS
  We implanted a single DES in 42 consecutive patients with stable angina. The plasma high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and matrix metalloproteinase-9 (MMP-9) levels were measured before, and 24 and 72 h after the procedure. Angiography and intravascular ultrasound were performed.
  
  
  RESULTS
  No relationship was noted between the baseline hs-CRP level and NIH. A significant positive correlation was noted between NIH and the hs-CRP level obtained at 24 h (r=0.435, P=0.004), and 72 h (r=0.334, P=0.031) after the procedure. Interestingly, there was a positive correlation between the change (Δ) in the hs-CRP level and NIH at 24 h (r=0.414, P=0.006). The fourth quartile of the hs-CRP at 24 h after percutaneous coronary intervention (PCI) had significantly larger volume of NIH than the first quartile (20.1±25.1 vs. 2.7±6.4 mm, P<0.05). Moreover, NIH in the fourth quartile (20.9±26.4 mm) was higher than the first quartile (3.3±8.6 mm) of the Δ hs-CRP level at 24 h (P<0.05) after the procedure. Although the IL-6 level at the baseline and 72 h after the procedure were positively correlated with NIH (r=0.337, P=0.029 and r=0.435, P=0.004, respectively), the Δ IL-6 level at any stage was not correlated with NIH. Neither the MMP-9 level nor the Δ MMP-9 level at any stage was correlated with NIH.
  
  
  CONCLUSIONS
  This prospective intravascular ultrasound study showed the inflammatory response after PCI, as measured by hs-CRP levels, but not the baseline hs-CRP level, predict NIH after DES implantation. Neither a change in the IL-6 nor MMP-9 levels at any stage after PCI reflected NIH.
authors: Department of Cardiology, Gil Hospital, Gachon University, Incheon, Republic of Korea.
authors: Woong Chol
authors: WC
authors: Kang
authors: Chan
authors: C
authors: Il Moon
authors: Kyounghoon
authors: K
authors: Lee
authors: Seung Hwan
authors: SH
authors: Han
authors: Soon Yong
authors: SY
authors: Suh
authors: Jeonggeun
authors: J
authors: Moon
authors: Mi Seung
authors: MS
authors: Shin
authors: Taehoon
authors: T
authors: Ahn
authors: Eak Kyun
authors: EK
authors: Shin
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D003331:Coronary Vessels / Q000276:immunology / Q000473:pathology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007249:Inflammation / Q000209:etiology* / Q000276:immunology / Q000473:pathology; D018836:Inflammation Mediators / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D016014:Linear Models; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011474:Prosthesis Design; D056910:Republic of Korea; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D017539:Tunica Intima / Q000276:immunology / Q000473:pathology*; D018084:Ultrasonography, Interventional
chemical_list: D015415:Biomarkers; C508600:IL6 protein, human; D018836:Inflammation Mediators; D015850:Interleukin-6; D002097:C-Reactive Protein; D020780:Matrix Metalloproteinase 9