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

Abstract

Thirty healthy individuals and 23 patients with coronary artery disease (CAD) verfied by coronary angiography were examined at the time of stenting and 6 months after percutaneous transluminal coronary angioplasty (PTCA) followed by intravascular ultrasound ( IVUS)-guided stenting and treatment with statins. Analysis of IVUS volumetric measurement for all stented segments after 6 months showed a small but significant decrease of mean minimal square area (18.39%), mean minimal lumen diameter ( 12.77%), and mean minimal lumen volume (12.66%), if compared with values obtained at the time of stenting. Before stenting we observed an increase of serum triglycerides, total cholesterol, low density lipoprotein cholesterol (LDL-cholesterol) concentrations, cholesterol to phospholipid ratio and the percentage of saturated fatty acids in phospholipids, while serum high density lipoprotein cholesterol (HDL-cholesterol) and phospholipids concentrations as well as the percentage of unsaturated fatty acid in phospholipids were lowered. Six months after stenting and treatment with statins a significant increase of HDL-cholesterol was found, while other indices of lipids mentioned above remained unchanged. Before stenting we have also observed increased scrum concentration of C'-reactive protein (CRP), neopterin, total homocysteine, and kynurenine concentrations, while pyridoxal-5-phosphate (P-5-P) concentration was lowered. Six months after stenting and treatment with statins, CRP, neopterin, homocysteine, and P-5-P serum concentrations remained unchanged, while kynurenine concentration increased (P <0.02). The results of this study as well as data of our previous investigations suggest that improvement of blood circulation of the heart muscle due to stenting does not normalise intercellular metabolism in patient with CAD. Some improvement observed in lipid metabolism can be the result of treatment with statins, although these changes in lipid metabolism were not followed by improvement of other biochemical indices examined in CAD patients of this study. At present the role of kynurenine in the course of CAD is obscure. Therefore further investigations are necessary.