(Circulation. 1995;91:1320-1325.)
© 1995 American Heart Association, Inc.
Articles |
Late Lumen Loss After Coronary Angioplasty Is Associated With the Activation Status of Circulating Phagocytes Before Treatment
From the Department of Biochemistry (A.P., L.E.A.d.W., J.F.K., W.S.), the Catheterization Laboratory (M.K., P.W.S.), and the Department of Epidemiology and Biostatistics (T.S.), Erasmus University Rotterdam, The Netherlands.
Correspondence to Wim Sluiter, Department of Biochemistry, Cardiovascular Research Institute (COEUR), Erasmus University Rotterdam, PO Box 1738, 3000 DR Rotterdam, The Netherlands.
Background The purpose of this pilot study was to identify biological risk factors for restenosis after percutaneous transluminal coronary angioplasty (PTCA) to predict the long-term outcome of PTCA before treatment.
Methods and Results To investigate whether blood granulocytes and
monocytes could determine luminal renarrowing after PTCA, several
characteristics of these phagocytes were assessed before angioplasty in
32 patients who underwent PTCA of one coronary artery and who had
repeat angiograms at 6-month follow-up. The plasma levels of
interleukin (IL)-1ß, tumor necrosis factor-
, IL-6, fibrinogen,
C-reactive protein, and lipoprotein(a) before angioplasty were assessed
as well. We found that the expression of the membrane antigens CD64,
CD66, and CD67 by granulocytes was inversely associated with the
luminal renarrowing normalized for vessel size (relative loss) at 6
months after PTCA, while the production of IL-1ß by stimulated
monocytes was positively associated with the relative loss. Next, these
univariate predictors were corrected for the established clinical risk
factors of dilation of the left anterior descending coronary artery and
current smoking, which were statistically significant classic
predictors in our patient group. Only the expression of CD67 did not
predict late lumen loss independent of these established clinical risk
factors. Multiple linear regression analysis showed that luminal
renarrowing could be predicted reliably (R2=.65;
P<.0001) in this patient group on the basis of the vessel
dilated and only two biological risk factors that reflect the
activation status of blood phagocytes, ie, the expression of CD66 by
granulocytes and the production of IL-1ß by stimulated monocytes.
Conclusions The results of the present study indicate that activated blood granulocytes prevent luminal renarrowing after PTCA, while activated blood monocytes promote late lumen loss. To validate this new finding, further study in an independent patient group is required.
Key Words: angioplasty • leukocytes • prognosis • risk factors • stenosis
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