title: An increase of VEGF plasma levels is associated with restenosis of drug-eluting stents.
abstract: OBJECTIVE
  Drug-eluting stents (DES) reduce late lumen loss compared to bare metal stents but were not able to eradicate in-stent restenosis (ISR) fully. Vascular endothelial growth factor (VEGF) may inhibit late lumen loss through accelerated reendothelialisation, but may also promote neointima formation by proinflammatory effects. The aim of this study was to evaluate whether endogenous plasma levels of VEGF are associated with development of ISR after implantation of DES.
  
  
  RESULTS
  We studied 85 patients who were treated with 159 DES. VEGF plasma levels were determined before and 24 hours after PCI. During the eight-month follow-up period, two patients (2.4%) died of cardiovascular causes and 12 patients (14.5% of patients, 7.6% of stents) developed angiographic ISR. Basal VEGF plasma levels were not different in patients with and without ISR at follow-up. In contrast to patients without ISR, VEGF increased significantly upon PCI in patients with ISR (p<0.005). Patients with a decrease of VEGF after PCI had a restenosis rate of 2.4% compared to a restenosis rate of 26.2% in patients with an increase of VEGF after the procedure (p<0.05). This was independent from clinical and angiographic risk factors.
  
  
  CONCLUSIONS
  Basal plasma levels of VEGF are not associated with the development of ISR. However, an increase of VEGF after PCI is associated with a dramatically increased ISR rate after implantation of DES.
authors.affiliation: Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
authors.forename: Katharina M
authors.initials: KM
authors.lastname: Katsaros
authors.forename: Stefan P
authors.initials: SP
authors.lastname: Kastl
authors.forename: Konstantin A
authors.initials: KA
authors.lastname: Krychtiuk
authors.forename: Randolph
authors.initials: R
authors.lastname: Hutter
authors.forename: Gerlinde
authors.initials: G
authors.lastname: Zorn
authors.forename: Gerald
authors.initials: G
authors.lastname: Maurer
authors.forename: Kurt
authors.initials: K
authors.lastname: Huber
authors.forename: Johann
authors.initials: J
authors.lastname: Wojta
authors.forename: Günter
authors.initials: G
authors.lastname: Christ
authors.forename: Walter S
authors.initials: WS
authors.lastname: Speidl
mesh_terms: D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000628:therapy*; D023903:Coronary Restenosis / Q000097:blood* / Q000000981:diagnostic imaging / Q000209:etiology*; D054855:Drug-Eluting Stents; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D011446:Prospective Studies; D012307:Risk Factors; D013997:Time Factors; D015854:Up-Regulation; D042461:Vascular Endothelial Growth Factor A / Q000097:blood*
chemical_list: C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A