Drug-eluting stent, but not bare metal stent, accentuates the systematic inflammatory response in patients.
OBJECTIVE
The systematic pro-inflammatory responses after percutaneous coronary intervention with drug-eluting stents (DES) remain poorly defined. Therefore, we compared the systematic pro-inflammatory state of circulating mononuclear cells (MNCs) between DES and bare metal stent (BMS) implantation.


METHODS
Patients with indications for treatment with stents were randomized in a 1:1 ratio to placement of DES or BMS. The primary endpoint was a change of pro-inflammatory state at 12 weeks post-procedure.


RESULTS
Thirty-six consecutive patients received DES or BMS. At 12 weeks after stent implantation, the lipid profile and high-sensitivity C-reactive protein (hs-CRP) improved significantly in both groups. The mRNA levels and plasma concentrations of interleukin-6, tumor necrosis factor-α and matrix metalloproteinase-9 were significantly elevated in the DES group, which was not observed in the BMS group. An increase in NF-κB binding activity and a decrease in PPAR-γ expression in MNCs were observed in the DES group, along with increases in IκB phosphorylation and p50 expression. However, similar changes were not observed in the BMS group.


CONCLUSIONS
Systematic inflammatory responses were accentuated after the patients were treated percutaneously with DES, despite their improved lipid profile and hs-CRP. These data may provide fundamental information for optimizing therapeutic strategy in the era of DES.
Department of Cardiology, First Affiliated Hospital of Xi'an Jiaotong University Health Science Center, Xi'an, PR China.
Junhui
J
Liu
Xiao-Zhen
XZ
Zhuo
Weimin
W
Liu
Zhaofei
Z
Wan
Xinhong
X
Wang
Weiping
W
Zhang
Shanshan
S
Gao
Zuyi
Z
Yuan
Yue
Y
Wu
D000704:Analysis of Variance; D002097:C-Reactive Protein / Q000378:metabolism; D023921:Coronary Stenosis / Q000628:therapy; D054855:Drug-Eluting Stents / Q000009:adverse effects; D004797:Enzyme-Linked Immunosorbent Assay; D000068338:Everolimus; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D015847:Interleukin-4 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D007963:Leukocytes, Mononuclear / Q000378:metabolism; D020780:Matrix Metalloproteinase 9 / Q000378:metabolism; D012333:RNA, Messenger / Q000378:metabolism; D020123:Sirolimus / Q000008:administration & dosage / Q000031:analogs & derivatives; D015607:Stents / Q000009:adverse effects*; D018746:Systemic Inflammatory Response Syndrome / Q000209:etiology*; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D007166:Immunosuppressive Agents; D015850:Interleukin-6; D012333:RNA, Messenger; D014409:Tumor Necrosis Factor-alpha; D015847:Interleukin-4; D002097:C-Reactive Protein; D000068338:Everolimus; D020780:Matrix Metalloproteinase 9; D020123:Sirolimus