BackgroundStudies have pointed out a higher mortality after coronary artery bypass
surgery (CABG) in patients with stent.ObjectiveTo evaluate inflammatory markers in peripheral blood cells and in coronary
artery tissue samples obtained during CABG in patients with stent compared
to controls.MethodsThe case series consisted of two groups, one with previous stent implantation
(n = 41) and one control (n = 26). The expression of the LIGHT, IL-6, ICAM,
VCAM, CD40, NFKB, TNF, IFNG genes was analyzed in peripheral blood cells
collected preoperatively. The coronary artery was evaluated for:
interleukin-6, ICAM, VCAM, CD40, NFKB, TNF-alpha and IFN-gamma by
immunohistochemistry. A total of 176 tissue samples were grouped for
analysis in: A1- arteries with stent (n = 38); A2- native arteries from
patients with stent in another artery (n = 68); and A3- arteries without
stent from controls undergoing routinely CABG surgery (n = 70). A
significance level of 0.05 was adopted.ResultsPatients with stent showed higher TNF (p = 0.03) and lower CD40 gene
expression (p = 0.01) in peripheral blood cells than controls without stent.
In coronary artery samples, the TNF-alpha protein staining was higher in the
group A1, not only in the intima-media layer (5.16 ± 5.05 vs 1.90
± 2.27; p = 0.02), but also in the adipose tissue (6.69 ± 3.87
vs 2.27 ± 4.00; p < 0.001). Furthermore, group A1 had a higher
interleukin-6 protein staining in adipose tissue than group A3 (p =
0.04).ConclusionWe observed a persistently higher systemic TNF expression associated with
exacerbated TNF-alpha and interleukin-6 local production in patients with
stents. This finding may contribute to a worse clinical outcome.