title: Relationship between biomarkers and subsequent clinical and angiographic restenosis after paclitaxel-eluting stents for treatment of STEMI: a HORIZONS-AMI substudy.
abstract: Drug-eluting stents (DES) reduce the incidence of in-stent restenosis (ISR) after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Whether the use of biomarkers might be of utility to identify patients who remain at risk for DES ISR after primary PCI has never been examined. A total of 26 biomarkers were measured at enrollment and 30 days and analyzed at a central core laboratory in 501 STEMI patients from the HORIZONS-AMI trial. All patients underwent primary PCI with the TAXUS paclitaxel-eluting stent (PES), were scheduled for routine angiographic follow-up at 13 months, and were followed for 3 years. Mean in-stent late-loss was 0.28 ± 0.57 mm, and target lesion revascularization (TLR) at 3 years occurred in 9.1 % of patients. Low levels of interleukin-6 (IL-6) and placental growth factor (PLGF) at admission were associated with both higher in-stent late loss and ischemia-driven TLR. Additionally, low admission levels of cardiotrophin-1 (CT-1) were associated with higher rates of ischemia-driven TLR. At 30-day follow-up lower values of IL-1ra (IL-1ra), matrix metalloproteinase 9 (MMP9), and myeloperoxidase (MPO), and a decline relative to admission in IL-1ra, monocyte chemotactic protein-1 (MCP-1), and MMP9 were associated with higher in-stent late loss. Low values of IL-6 at 30 days were also associated with ischemia-driven TLR. After multivariate adjustment, only MPO at 30 days and a decline of MCP-1 between admission and 30 days were associated with in-stent late loss, and only CT-1 was associated with TLR. MPO at 30 days and a decline of MCP-1 between admission and 30 days were independently associated with in-stent late loss, and CT-1 was associated with TLR. Additional studies to confirm and validate the utility of these biomarkers are warranted.
authors.affiliation: Cardiovascular Research Foundation, New York, NY, USA.
authors.forename: Bimmer E
authors.initials: BE
authors.lastname: Claessen
authors.forename: Gregg W
authors.initials: GW
authors.lastname: Stone
authors.forename: Roxana
authors.initials: R
authors.lastname: Mehran
authors.forename: Bernhard
authors.initials: B
authors.lastname: Witzenbichler
authors.forename: Bruce R
authors.initials: BR
authors.lastname: Brodie
authors.forename: Jochen
authors.initials: J
authors.lastname: Wöhrle
authors.forename: Adam
authors.initials: A
authors.lastname: Witkowski
authors.forename: Giulio
authors.initials: G
authors.lastname: Guagliumi
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
authors.forename: José P S
authors.initials: JP
authors.lastname: Henriques
authors.forename: Jan G P
authors.initials: JG
authors.lastname: Tijssen
authors.forename: Elias A
authors.initials: EA
authors.lastname: Sanidas
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Chantziara
authors.forename: Diaa
authors.initials: D
authors.lastname: Hakim
authors.forename: Selene
authors.initials: S
authors.lastname: Leon
authors.forename: Ke
authors.initials: K
authors.lastname: Xu
authors.forename: George D
authors.initials: GD
authors.lastname: Dangas
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D017023:Coronary Angiography; D016207:Cytokines / Q000097:blood; D054855:Drug-Eluting Stents; D005260:Female; D005500:Follow-Up Studies; D006083:Graft Occlusion, Vascular / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D020780:Matrix Metalloproteinase 9 / Q000097:blood; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood* / Q000000981:diagnostic imaging / Q000628:therapy; D017239:Paclitaxel / Q000494:pharmacology*; D009195:Peroxidase; D000072483:Placenta Growth Factor; D011257:Pregnancy Proteins / Q000097:blood; D050257:Tubulin Modulators / Q000494:pharmacology*
chemical_list: D015415:Biomarkers; D016207:Cytokines; C507763:IL1RN protein, human; C508600:IL6 protein, human; D053590:Interleukin 1 Receptor Antagonist Protein; D015850:Interleukin-6; C000608036:PGF protein, human; D011257:Pregnancy Proteins; D050257:Tubulin Modulators; D000072483:Placenta Growth Factor; C092073:cardiotrophin 1; D009195:Peroxidase; D020780:Matrix Metalloproteinase 9; D017239:Paclitaxel