Inflammation, Homocysteine, Pyridoxal-5-phosphate and Lipids in Patients with Coronary Artery Disease before and Six Months after Coronary Angioplasty Followed by Stent Implantation

Abstract

Thirty healthy individuals as well as 42 patients with coronary artery disease (CAD) verified by coronary angiography were examined before and 6 month after percutaneus transluminal coronary angioplasty followed by stent implantation and statins treatment. Such therapy positively influenced high sensitivity C-reactive protein, total cholesterol, high density lipoprotein cholesterol, and low density lipoprotein cholesterol concentration in blood scrum as well as cholesterol to phospholipid ratio. By contrast, scrum concentration of neopterin, total homocysteine, pyridoxal-5-phosphate, triglycerol and phospholipids as well as fatty acid content of phospholipids remained unchanged or became worse. These changes were followed by restenosis or new coronary events in half of observed CAD patients. Findings suggest that cholesterol concentration has no pivotal role, neither in restenosis nor in the development of coronary events after stent implantation. Elevated serum concentration of neopterin and homocysteine before and 6 months after stent implantation appear more significant indicator of new coronary events in CAD patients. Further investigations arc necessary to substantiate these observations.

Intravascular Ultrasound Data and Results of Serum Biochemical Indices at the Time of Stenting and after Six Months in Patients with Coronary Artery Disease

“…homocysteine, kynurenine were elevated, while HDL-cholestcrol, phospholipids, unsaturated fatty acid content in phospholipids and P-5-P concentrations were lowered. This result corresponds well with data of our prev ious investigations (7,11,12,22).…”

“…Therefore further investigations are necessary. The results of this study as well as data of our previous investigations (22) allow to conclude that improvement of circulation in heart muscle due to PCTA followed by stent implantation does not normalise intercellular metabolism found in CAD. The treatment with statins is followed by an elevation of the HDL-cholestcrol concentration in serum, but these changes in lipid metabolism have no effect on other risk factors determined in blood scrum of CAD patients.…”