title: The late-phase inflammatory response after drug-eluting stent implantation.
abstract: Recent advances in drug-eluting stent (DES) technology have succeeded in preventing restenosis. In addition to inhibiting smooth muscle cell proliferation, DES greatly inhibits the local inflammatory response in the acute phase after implantation, leading to prevention of restenosis. However, a unique issue in DES implantation is an impairment of reendothelialization, which may result in abnormal wound healing. Consequently, a late-phase inflammatory relapse could appear in the long term after DES implantation. In this study, we measured serum levels of inflammatory markers, including interleukin (IL)-6, IL-8, tumor necrosis factor-α, monocyte chemoattractant protein-1, matrix metalloproteinase-9, and myeloperoxidase, as well as high-sensitivity C-reactive protein at follow-up coronary angiography (mean 9 months) in 54 patients who received DES stenting who did not experience restenosis, and compared them with 51 patients receiving bare-metal stents (BMS) without restenosis. The level of IL-6 was over the measurement threshold (≥2.22 pg/ml) in 12 patients (21 %) in the DES group, but in only 2 patients (4 %) in the BMS group (P = 0.003). IL-8 was significantly higher in the DES group than in the BMS group (4.51 ± 2.40 vs 3.84 ± 1.34 pg/ml, P = 0.015). The levels of other biomarkers were similar between the two groups. DES showed an increase in inflammatory cytokines in the late phase after implantation in comparison with patients who received BMS, suggesting late-stage inflammation. Therefore, the wound-healing response after DES implantation might be different from that after BMS.
authors: Department of Cardiovascular Medicine, Dokkyo Medical University School of Medicine, 880 Kitakobayashi Mibu, Tochigi, 321-0293, Japan, taguchi@dokkyomed.ac.jp.
authors: Isao
authors: I
authors: Taguchi
authors: Shuichi
authors: S
authors: Yoneda
authors: Shichiro
authors: S
authors: Abe
authors: Shigeru
authors: S
authors: Toyoda
authors: Takahisa
authors: T
authors: Nasuno
authors: Setsu
authors: S
authors: Nishino
authors: Michiya
authors: M
authors: Kageyama
authors: Michiaki
authors: M
authors: Tokura
authors: Mikie
authors: M
authors: Ogawa
authors: Koichi
authors: K
authors: Node
authors: Teruo
authors: T
authors: Inoue
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003430:Cross-Sectional Studies; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis / Q000209:etiology*; D018836:Inflammation Mediators / Q000097:blood*; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects* / Q000295:instrumentation*; D011474:Prosthesis Design; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D018836:Inflammation Mediators
references: Clin Diagn Lab Immunol. 2003 Jan;10(1):133-9
references: 12522051
references: JAMA. 2001 Nov 7;286(17):2107-13
references: 11694151
references: Cardiovasc Pathol. 2012 Mar-Apr;21(2):e19-22
references: 21489821
references: Coron Artery Dis. 2013 Aug;24(5):368-73
references: 23744617
references: Circ Res. 1994 Jul;75(1):1-7
references: 8013067
references: Lancet. 2007 Sep 15;370(9591):914-5
references: 17869619
references: J Am Coll Cardiol. 2006 Jul 4;48(1):193-202
references: 16814667
references: Circ J. 2009 Apr;73(4):615-21
references: 19282604
references: Circulation. 2005 May 3;111(17):2257-73
references: 15867193
references: Int J Cardiol. 2008 Mar 14;124(3):319-25
references: 17442429
references: J Hypertens. 2003 Oct;21(10):1787-803
references: 14508181
references: J Immunol Methods. 1999 Jul 30;227(1-2):41-52
references: 10485253
references: Cardiovasc Pathol. 2012 Nov-Dec;21(6):511-4
references: 22356902
references: Clin Chem. 1999 Dec;45(12):2136-41
references: 10585345
references: FEBS Lett. 1988 May 23;232(2):347-50
references: 2454206
references: Heart Vessels. 2012 Jan;27(1):110-3
references: 21526419
references: Circulation. 2005 Jul 12;112(2):270-8
references: 15998681
references: J Clin Invest. 1996 Nov 15;98(10):2277-83
references: 8941644
references: JACC Cardiovasc Interv. 2011 Oct;4(10):1057-66
references: 22017929
references: Circulation. 2007 Feb 6;115(5):553-61
references: 17261663
references: Circulation. 2001 Sep 4;104(10):1188-93
references: 11535578
references: Heart Vessels. 2013 May;28(3):308-15
references: 22526379
references: Heart Vessels. 2009 Jul;24(4):308-12
references: 19626405
references: Circulation. 2004 Feb 17;109(6):701-5
references: 14744976
references: Heart Vessels. 2009 Jul;24(4):271-6
references: 19626399
references: J Thromb Haemost. 2007 Sep;5(9):1795-800
references: 17723116