Abstract 4730: Long-Term Local Inflammatory Response After Coronary Artery Stenting: Bare Metal vs Sirolimus-Eluting vs Paclitaxel-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 (16–20mm in stent-length) for isolated proximal left anterior descending arterial stenosis, with no evidence of restenosis, were studied. Twenty patients had been stented with BMS, 21 with sirolimus-eluting stent (SES), and 11 with paclitaxel-eluting stent (PES). 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 SES and PES groups than in the BMS group (0.09±0.07, 0.12±0.07 vs. −0.01±0.06 ng/ml, p<0.01, respectively). There were no significant differences in ΔPTX3 between the SES and PES groups. The Δhs-CRP had no significant differences among the three groups (356±241 vs. 309±144 vs. 361±276 ng/ml, NS).
Conclusions: More increased local inflammatory response was observed long term after DES implantation. These findings may be associated with late catch-up phenomenon and further progression of coronary atherosclerosis.