title: Monocyte Chemoattractant Protein-1 Levels and Postangioplasty Restenosis of Arteriovenous Fistulas.
abstract: Inflammation is relevant in restenosis of atherosclerotic vascular diseases, but its role in dialysis arteriovenous fistula remains unknown. In animal studies, upregulation of monocyte chemoattractant protein-1 has been shown in venous segments of arteriovenous fistula. We, therefore, aimed to investigate serial changes in circulating monocyte chemoattractant protein-1 after percutaneous transluminal angioplasty of dialysis arteriovenous fistulas and its relation to restenosis.
  
  
  
  Fifty-nine patients with dysfunctional arteriovenous fistulas that were referred for percutaneous transluminal angioplasty were enrolled prospectively between January of 2010 and July of 2012. Three of them were excluded due to percutaneous transluminal angioplasty failure or acute infection. Blood was sampled from arteriovenous fistulas at baseline, 2 days, 2 weeks, and 3 months after percutaneous transluminal angioplasty. Clinical follow-up was continued monthly for 3 months. Angiographic follow-up was arranged at the end of 3 months. Seventeen patients without significant stenosis were enrolled as the control group.
  
  
  
  Fifty-six patients completed clinical follow-up. Significant increases in monocyte chemoattractant protein-1 were observed at 2 days and 2 weeks (both P<0.001) after percutaneous transluminal angioplasty. Twenty-three (41%) patients had symptomatic restenosis. The restenosis group had a higher percentage change in monocyte chemoattractant protein-1 levels at 2 days (median =47%; interquartile range, 27%-65% versus median =17%; interquartile range, 10%-25%; P<0.001) after percutaneous transluminal angioplasty compared with the patent group. Fifty-two patients completed angiographic follow-up. A positive correlation between relative luminal loss and monocyte chemoattractant protein-1 increase at 2 days after percutaneous transluminal angioplasty was found (r=0.53; P<0.001). In multivariate analysis, postangioplasty monocyte chemoattractant protein-1 increase at 2 days was an independent predictor of restenosis. Using receiver operator characteristic analysis, >25% postangioplasty increase of monocyte chemoattractant protein-1 was significantly associated with restenosis after percutaneous transluminal angioplasty (hazard ratio, 5.36; 95% confidence interval, 1.81 to 15.8).
  
  
  
  Circulating monocyte chemoattractant protein-1 levels were elevated 2 days and 2 weeks after percutaneous transluminal angioplasty. Early postangioplasty increase of monocyte chemoattractant protein-1 level was associated with restenosis of arteriovenous fistulas.
authors: Cardiovascular Center, National Taiwan University Hospital, Hsinchu Branch, Institute of Biomedical Engineering, National Tsing-Hua University, Hsinchu, Taiwan.|College of Medicine, National Taiwan University and School of Medicine and.|College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Chih-Cheng
authors: CC
authors: Wu
authors: Cardiovascular and.
authors: Tsung-Yan
authors: TY
authors: Chen
authors: College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Mu-Yang
authors: MY
authors: Hsieh
authors: College of Medicine, National Taiwan University, Taipei, Taiwan.
authors: Lin
authors: L
authors: Lin
authors: Hemodialysis Centers, National Taiwan University Hospital, Hsinchu Branch, Hsinchu, Taiwan.
authors: Chung-Wei
authors: CW
authors: Yang
authors: Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan; and.
authors: Shao-Yuan
authors: SY
authors: Chuang
authors: Institutes of Physiology and Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.|Division of Nephrology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
authors: Der-Cheng
authors: DC
authors: Tarng
mesh_terms: D000368:Aged; D017130:Angioplasty / Q000379:methods; D001166:Arteriovenous Shunt, Surgical / Q000009:adverse effects*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000378:metabolism; D016022:Case-Control Studies; D018932:Chemokine CCL2 / Q000097:blood*; D003251:Constriction, Pathologic / Q000097:blood / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D012372:ROC Curve; D012008:Recurrence; D006435:Renal Dialysis; D013997:Time Factors; D014463:Ultrasonography; D014654:Vascular Patency
chemical_list: D015415:Biomarkers; D018932:Chemokine CCL2; D015850:Interleukin-6; D002097:C-Reactive Protein
keywords: angioplasty; arterioveous fistula; hemodialysis; monocyte chemoattractant protein-1; stenosis