Abstract 17586: Interleukin-33 Serum Levels After Coronary Stent Implantation Predict In-Stent Restenosis
Background. Inflammation is a hallmark in the development of recurrent luminal narrowing after coronary stent implantation. Interleukin-33 (IL-33) is a recently described member of the IL-1 family of cytokines and is a ligand for the ST2 receptor. The predictive value of IL-33 for the development of in-stent restenosis (ISR) is not known.
Methods. We included 387 consecutive patients undergoing percutaneous coronary intervention (PCI) of whom 193 had stable angina, 93 non-ST elevation myocardial infarction (NSTEMI), and 101 ST-elevation MI (STEMI), respectively. Blood was taken directly before and 24 hours after stent implantation. Plasma levels of IL-33 were measured by a specific ELISA. The presence of ISR was initially evaluated by clinical means. When presence of myocardial ischemia was suspected, coronary angiography was performed to confirm the suspected diagnosis of ISR.
Results. Bare metal stents (BMS) were used in 283 and drug eluting stents (DES) were used in 104 patients. Clinical ISR was present in total in 34 patients (8.8 %). IL-33 was detectable in 185 patients and was below detection limit in 202 patients. In patients with decreased IL-33 (n=95), unchanged or non-detectable levels (n=210) or increased levels of IL-33 after PCI (n=82), ISR-rate was 2.1%, 9.5% and 14.6%, respectively (p<0.05). Accordingly, patients with ISR showed a significant increase of IL-33 upon PCI (p<0.05). This association was independent from clinical presentation and risk factors as well as numbers and type of stents.
Conclusion. In patients with both stable and unstable coronary artery disease, an increase of IL-33 serum levels after stent implantation is associated with a higher rate of in-stent restenosis.
- © 2012 by American Heart Association, Inc.