title: Determinants of neointimal proliferation and stent coverage after intracoronary therapy with drug-eluting devices in stable coronary artery disease: role of endothelial progenitor cells and interleukin-1 family cytokines.
abstract: BACKGROUND
  Endothelial progenitor cells (EPCs) and cytokines seem to play a pivotal role in arterial healing after stent implantation. Using optical coherence tomography (OCT) as a high-resolution imaging technique, we aimed to assess the influence of circulating EPCs and levels of Il-1 cytokines on stent coverage and in-stent proliferation.
  
  
  METHODS
  Eighty-nine patients were randomly treated with either Xience V drug-eluting stent (DES; n = 48) or bare-metal stent (BMS) postdilated with the SeQuent Please drug-eluting balloon (DEB; n = 41). EPC populations (CD34+/CD133+ and CD34+/CD133+/KDR+ EPC) and cytokines (Il-1ra, Il-18, and Il-1α) were measured before percutaneous coronary intervention using flow cytometry or immunoassay. Vessel remodeling was analyzed using coronary angiography and OCT at 6-month follow-up.
  
  
  RESULTS
  Indexed neointimal volume and maximal proliferation thickness correlated inversely with EPC levels in the entire study population (r = -0.220; P=.04 and r = -0.253; P=.02) and the BMS + DEB subgroup (r = -0.344; P=.03 and r = -0.374; P=.02). Late lumen loss (LLL) was associated with the proatherogenic Il-18 concentration in the main population (r = 0.342; P=.01) and the BMS + DEB group (r = 0.471; P=.01). In the DES subgroup, associations with proliferation and LLL were lacking. Associations for stent strut coverage were not observed.
  
  
  CONCLUSIONS
  A high EPC count seems to be a favorable individual patient factor, since it was associated with less instent proliferation. Contrarily, high Il-18 levels lead to more LLL, which emphasizes its proatherogenic properties.
authors.affiliation: 1st Clinic of Medicine, Division of Cardiology, University Hospital of Jena, Germany, Erlanger Allee 101, 07747 Jena, Germany. sylvia.otto@med.uni-jena.de.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Otto
authors.forename: Kristina
authors.initials: K
authors.lastname: Nitsche
authors.forename: Christian
authors.initials: C
authors.lastname: Jung
authors.forename: Johannes
authors.initials: J
authors.lastname: Gassdorf
authors.forename: Florian
authors.initials: F
authors.lastname: Janiak
authors.forename: Björn
authors.initials: B
authors.lastname: Goebel
authors.forename: Hans R
authors.initials: HR
authors.lastname: Figulla
authors.forename: Tudor C
authors.initials: TC
authors.lastname: Poerner
mesh_terms: D000368:Aged; D002452:Cell Count; D049109:Cell Proliferation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D054855:Drug-Eluting Stents; D066026:Endothelial Progenitor Cells / Q000502:physiology*; D000068338:Everolimus / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D058426:Neointima / Q000000981:diagnostic imaging / Q000503:physiopathology*; D017239:Paclitaxel / Q000008:administration & dosage; D011379:Prognosis; D041623:Tomography, Optical Coherence
chemical_list: D007375:Interleukin-1; D000068338:Everolimus; D017239:Paclitaxel