Soluble adhesion molecules in patients with acute coronary syndrome after percutaneous coronary intervention with drug-coated balloon, drug-eluting stent or bare metal stent.
Adhesion molecules play an important role in inflammation, atherosclerosis and coronary artery disease (CAD). These molecules are expressed on the surface of dysfunctional endothelial cells, causing inflammatory cells from the circulation to adhere and migrate through the endothelium. Their expression is upregulated in acute coronary syndrome (ACS) and after percutaneous coronary intervention (PCI). The contact between stent struts and endothelium upregulates endothelial cell gene expression, endothelial cell activation and inflammation. The paclitaxel or sirolimus eluting stents inhibited expression of adhesion molecules in several studies and reduced the incidence of major adverse cardiac events (MACE) after drug-eluting stent (DES) over bare metal stent (BMS) implantation. Therefore, we propose that elevated serum levels of the soluble adhesion molecules after primary PCI in patients treated with BMS or DES implantation versus drug-coated balloon (DCB) application to the vulnerable coronary plaque might be a predictor of MACE and further adverse outcomes. Consequently, DCB-only strategy in patients with ACS might be a superior approach in comparison to BMS implantation and non-inferior approach when compared to DES implantation.
Department of Cardiovascular Disease, University Hospital Rijeka, Rijeka 51000, Croatia. Electronic address: vtomulic@gmail.com.
Vjekoslav
V
Tomulić
Department of Cardiovascular Disease, University Hospital Rijeka, Rijeka 51000, Croatia.
David
D
Gobić
Department of Cardiovascular Disease, University Hospital Rijeka, Rijeka 51000, Croatia.
Davorka
D
Lulić
Department of Cardiovascular Disease, University Hospital Rijeka, Rijeka 51000, Croatia.
David
D
Židan
Department of Cardiovascular Disease, University Hospital Rijeka, Rijeka 51000, Croatia.
Luka
L
Zaputović
D054058:Acute Coronary Syndrome / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D050197:Atherosclerosis / Q000188:drug therapy; D015815:Cell Adhesion Molecules / Q000097:blood*; D003324:Coronary Artery Disease / Q000188:drug therapy / Q000378:metabolism; D023903:Coronary Restenosis; D016503:Drug Delivery Systems; D054855:Drug-Eluting Stents; D042783:Endothelial Cells / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000188:drug therapy; D018799:Intercellular Adhesion Molecule-1 / Q000378:metabolism; D008670:Metals / Q000737:chemistry*; D019007:P-Selectin / Q000378:metabolism; D017239:Paclitaxel / Q000627:therapeutic use; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D020123:Sirolimus / Q000627:therapeutic use; D015854:Up-Regulation; D019010:Vascular Cell Adhesion Molecule-1 / Q000378:metabolism
D015815:Cell Adhesion Molecules; D008670:Metals; D019007:P-Selectin; D019010:Vascular Cell Adhesion Molecule-1; D018799:Intercellular Adhesion Molecule-1; D017239:Paclitaxel; D020123:Sirolimus