Abstract 4151: Long-Term Local Inflammatory Response After Coronary Artery Stenting With Drug-Eluting Stent
Background: The long-term effects of drug-eluting stent (DES) on coronary local inflammation are not known. Pentraxin3 (PTX3) is produced in response to primary proinflammatory signals from vascular endothelial cells and macrophages instead of from the liver.
Objectives: We evaluated the local release of PTX3 and high sensitivity C-reactive protein (hs-CRP) as a local inflammatory marker in nonrestenotic coronary arteries more than six months following DES and bare metal stent (BMS) implantation.
Methods: Fifty-two patients treated six months earlier with a coronary stenting for isolated proximal left anterior descending (LAD) stenosis, with no evidence of restenosis, were studied. Twenty patients had been stented with BMS, and 32 had been with DES. We measured serum PTX3 and hs-CRP levels sampled in coronary sinus (CS) and sinus of Valsalva (V). The translesional PTX3 and hs-CRP gradients (Δ) were defined as CS level minus V level.
Results: There were no significant differences in risk factors for atherosclerosis among the three groups. The ΔPTX3 was larger in the DES group than in the BMS group (0.11±0.05 vs. −0.01±0.05 ng/ml, p<0.01). The Δhs-CRP had no significant differences between the two groups (315±177 vs. 361±276 ng/ml, NS). The ΔPTX3 was higher than in the long DES (>18mm in length) group (n=19) than in the short group (≤18mm, n=13) (0.15±0.08 vs. 0.02±0.10 ng/ml, p<0.05).
Conclusions: More increased local inflammatory response was observed long term after DES implantation as compared to BMS. Inflammatory response was more remarkable in the artery treated with longer DES implantation. These findings may be associated with a disorder of endothelial function and further progression of coronary atherosclerosis.