Pre-intervention eosinophil cationic protein serum levels predict clinical outcomes following implantation of drug-eluting stents

Abstract

This study shows for the first time an association between baseline ECP levels and the occurrence of MACEs in patients undergoing implantation of DES. Further studies are warranted to establish whether in this setting ECP is a risk marker or plays a contributory pathogenetic role.

Allergic Inflammation Is Associated With Coronary Instability and a Worse Clinical Outcome After Acute Myocardial Infarction

“…ECP has been found to be associated with coronary atherosclerotic burden and with a poor clinical outcome after implantation of both bare metal and drugeluting stents. 9,10,26 In this study, we measured ECP in a population of STEMI patients at the time of PPCI. We found that serum levels of ECP predicted MACEs at 24 months, independently of baseline ejection fraction.…”

“…10,26 Our study is focused on an unselected coronary artery disease population and not focused on patients with previous history of allergic disease. Accordingly, median value of ECP (12.8 μg/L) in our population was lower than the upper normal limit (20 μg/L) recommended by allergologist.…”

“…Indeed, target lesion revascularization in this study was a major component of MACEs. 10 Moreover, the lack of correlation between eosinophil count and CD66 and CD69 or ECP levels suggests that eosinophil activation more than eosinophil number should be taken into account for risk stratification of patients presenting with an ACS.…”

“…7,8 Of note, we reported that higher eosinophil cationic protein (ECP) levels were associated to the atherosclerotic burden and to a worse prognosis in patients undergoing stent implantation. 9,10 Moreover, in a postmortem study, eosinophil infiltration was found at the site of late drug-eluting stent thrombosis. …”

Late Stent Thrombosis After Drug-Eluting Stent

“…Efforts toward identifying systemic biomarkers that could potentially be predictive of events or at least subjects at risk are most wanted. Recognizing the local nature of the processes, this may not be feasible, although encouraging data have recently been reported by Niccoli et al 7 Baseline plasma levels of eosinophil cationic protein, a marker of eosinophil activation, were shown to be predictive of future events after stent implantation. Several candidate markers addressing macrophage or T-cell activation could equally be studied sequentially.…”