title: Association between inflammatory biomarkers and in-stent restenosis tissue features: an Optical Coherence Tomography Study.
abstract: OBJECTIVE
  Inflammatory reaction after stent implantation is associated with in-stent restenosis (ISR). We assessed the association of optical coherence tomography (OCT) features of neointima with systemic levels of high-sensitivity C-reactive protein (hs-CRP) and eosinophil cationic protein (ECP) measured at the time of ISR detection.
  
  
  RESULTS
  Patients presenting with symptomatic angiographically documented ISR (diameter stenosis ≥ 50% by visual estimation) were included. Quantitative OCT analysis included the measurement of minimal lumen diameter, minimal luminal area, stent and neointimal area, stent and restenosis length, restenotic tissue burden, and symmetry ratio. Qualitative OCT analysis included the assessment of ISR plaque type, neointimal tissue structure, lumen shape, presence of microvessels and calcific nodules. At the time of ISR detection hs-CRP and ECP levels were measured, and statistical analysis was performed using as cut-off 3 mg/L and 4.5 µg/L, respectively. Our population included 40 patients, 24 bare metal stents and 16 drug-eluting stents. Patients with high hs-CRP levels had a higher restenostic tissue symmetry ratio (0.56 ± 0.17 vs. 0.42 ± 0.13, P = 0.01) when compared with patients with low hs-CRP levels. Patients with high ECP levels had a higher neointimal burden (70 ± 14 vs. 64 ± 11, P = 0.05) in comparison with patients with low ECP levels.
  
  
  CONCLUSIONS
  Inflammatory biomarkers assessed at the time of ISR detection are associated with different aspects of neointimal tissue. While hs-CRP seems to have a role in neointimal tissue shape, ECP is related to a neointimal burden.
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy gniccoli73@hotmail.it.
authors.forename: Giampaolo
authors.initials: G
authors.lastname: Niccoli
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Dato
authors.affiliation: Cardiology Research Center, Moscow, Russia.
authors.forename: Asiya E
authors.initials: AE
authors.lastname: Imaeva
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Roberta
authors.initials: R
authors.lastname: Antonazzo Panico
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Roberto
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Burzotta
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Aurigemma
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Trani
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Gramegna
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Antonio Maria
authors.initials: AM
authors.lastname: Leone
authors.affiliation: Cardiovascular Department, San Donato Hospital, Arezzo, Italy.
authors.forename: Italo
authors.initials: I
authors.lastname: Porto
authors.affiliation: Cardiovascular Science Department, Sacred Heart University, L.go Gemelli 8, 00168 Rome, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Crea
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism*; D017023:Coronary Angiography; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000000981:diagnostic imaging; D054855:Drug-Eluting Stents; D047150:Eosinophil Cationic Protein / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D058426:Neointima / Q000473:pathology; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D041623:Tomography, Optical Coherence / Q000379:methods*
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D047150:Eosinophil Cationic Protein