Abstract 15201: Long-Term Local Inflammatory and Coagulative Responses after Coronary Artery Stenting with Drug-Eluting Stent
Background: The long-term effects of drug-eluting stent (DES) on coronary local inflammation and coagulative response are not known. Pentraxin3 (PTX3) is produced in response to primary proinflammatory signals from vascular endothelial cells and macrophages instead of from the liver. Prothrombin fragment F1+2 (frF1+2) is considered a very sensitive marker for hypercoagulable states in human. Objectives: We evaluated the local release of PTX3 and frF1+2 as a local inflammatory and coagulative marker respectively in nonrestenotic coronary arteries more than eight months following DES and bare metal stent (BMS) implantation.
Methods: Eighty-seven patients treated six months earlier with a coronary stenting for isolated proximal left anterior descending arterial stenosis, with no evidence of restenosis, were studied. Forty patients had been stented with BMS, 47 with sirolimus-eluting stent (SES). We measured serum PTX3 and frF1+2 levels sampled in coronary sinus(CS) and sinus of Valsalva(V). The translesional PTX3 and frF1+2 gradients(Δ) were defined as CS level minus V level.
Results: There were no significant differences in coronary risk factors between the two groups. The ΔPTX3 and ΔfrF1+2 were larger in the SES group than in the BMS group (0.14±0.09 vs 0.01±0.06 ng/ml, p<0.01 and 29±19 vs 5±14 pmol/l, p<0.05, respectively). The ΔPTX3 correlated positively with the ΔfrF1+2 (r=0.56, p<0.01) in the SES group, whereas there were no significant correlation in the BMS group.
Conclusions: More increased local inflammatory response was observed and related with local hypercoagulability long term after DES implantation. These findings may be associated with late catch-up phenomenon and further progression of coronary atherosclerosis.
- © 2010 by American Heart Association, Inc.