Abstract 17232: The Adipokine Vaspin Inhibits Smooth Muscle Migration in vitro and the Development of Coronary in-Stent Restenosis in vivo
Background: Percutaneous coronary intervention (PCI) represents the most important treatment modality of coronary artery stenosis. In-stent restenosis (ISR) is still a limitation for the long-term outcome despite the introduction of drug eluting stents. Adipokines may directly influence vessel wall homeostasis by influencing the function of endothelial cells and arterial smooth muscle cells (SMC). Visceral adipose tissue-derived serpin (vaspin) was recently identified as a member of serine protease inhibitor family and serveral studies could demonstrate a relation to metabolic diseases like diabetes which also plays an important role in in the development of ISR. The aim of this study was to investigate a role of vaspin in SMC migration in vitro and development of ISR in vivo.
Methods: Human coronary artery smooth muscle cell (HCASMC) migration was analyzed by an in-vitro migration assay with different concentrations (0.004 ng/ml up to 40 ng/ml) of vaspin. The development of ISR was studied in 74 patients with stable coronary artery disease who underwent elective and successful percutaneous coronary intervention (PCI) with implatation of drug eluting stents. Blood samples were taken directly before PCI. Vaspin plasma levels were measured by specific elisa. ISR was evaluated eight months later by coronary angiography.
Results: During the follow up period, 15 patients developed ISR. Patients with ISR had significantly lower vaspin plasma levels compared to patients without ISR (0.213 ng/ml vs 0.382 ng/ml; p=0.001). Further we could demonstrate that vaspin nearly abolishes serum induced SMC migration (100% vs. 7%; p<0.001) in a biphasic manner.
Conclusion: We were able to show for the first time that the adipokine vaspin inhibits SMC migration in vitro. In addition, the occurrence of ISR after PCI with implantation of DES was significantly associated with low vaspin plasma levels before intervention. Determination of vaspin plasma levels before PCI might be helpful in the identification of patients with high risk for development of ISR after stent implantation.
- © 2010 by American Heart Association, Inc.