Interleukins and inflammatory markers in in-stent restenosis after femoral percutaneous transluminal angioplasty.
BACKGROUND
Inflammatory activity may influence results of percutaneous transluminal angioplasty (PTA). The purpose of this study was to evaluate the relationship between (1) proinflammatory markers (interleukin [IL]-6, IL-8, tumor necrosis factor α (TNF-α), and highly sensitive C-reactive protein [CRP]); (2) type 1 T helper cell marker (IL-12); and (3) Type 2 T helper cell marker (transforming growth factor-β [TGF-β]) and in-stent restenosis, 6 months after femoral PTA with stent implantation.


METHODS
We performed a single-center prospective study with 26 patients with peripheral artery disease requiring PTA and stenting. As control, we studied 26 patients who were submitted to diagnostic angiography. Serum samples were collected before stent implantation, 24 hr and 6 months after the procedure. To detect restenosis, a new angiography was obtained at 6 months.


RESULTS
Restenosis was observed in 10 (38.5%) patients who underwent PTA and stenting. There was a trend to increased levels of IL-6, TNF-α, TGF-β, and IL-12 24 hr after PTA and stenting compared with pretreatment. IL-8 levels showed a statistically significant reduction 24 hours after versus pretreatment (P < 0.05), 6 months vs. pretreatment, and 6 months vs. 24 hr (P < 0.01). There was no statistical difference between cytokine levels when comparing restenosis and no restenosis groups. CRP levels were already high at pretreatment.


CONCLUSIONS
No inflammatory marker was independently identified as risk factor for in-stent restenosis, 6 months after femoral PTA with stent implantation. The question that remains is whether acute phase reactants will be clinically useful to predict the individual risk for in-stent restenosis.
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Paula Vasconcelos
PV
Araújo
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Maurício Serra
MS
Ribeiro
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Marcelo Bellini
MB
Dalio
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Laura Andrade
LA
Rocha
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Fernanda
F
Viaro
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Renata
R
Dellalibera Joviliano
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Carlos Eli
CE
Piccinato
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil.
Paulo Roberto Barbosa
PR
Évora
Division of Vascular and Endovascular Surgery, Department of Surgery and Anatomy, Ribeirão Preto School of Medicine, University of São Paulo, São Paulo, Brazil. Electronic address: eejov@fmrp.usp.br.
Edwaldo Edner
EE
Joviliano
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000800:Angioplasty, Balloon / Q000009:adverse effects* / Q000295:instrumentation*; D015415:Biomarkers / Q000097:blood; D001938:Brazil; D016022:Case-Control Studies; D003251:Constriction, Pathologic; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D011859:Radiography; D012008:Recurrence; D012307:Risk Factors; D015607:Stents; D013997:Time Factors
D015415:Biomarkers; D018836:Inflammation Mediators; D007378:Interleukins