Systemic Inflammation After Drug-Eluting Stent Placement

Gogo, Prospero; Schneider, David J.; Watkins, Matthew W.; Terrien, Edward F.; Sobel, Burton E.; Dauerman, Harold L.

doi:10.1007/s11239-005-1378-6

Cited by 33 publications

(29 citation statements)

References 21 publications

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“…This corroborates the results of elevated inflammatory markers that are associated with worse outcome after PCI [23][24][25]. Our findings enable the dissection of the inflammatory response and its effects on vascular repair.…”

Section: Discussionsupporting

confidence: 89%

Innate immunity has a dual effect on vascular healing: Suppression and aggravation of neointimal formation and remodeling post-endotoxin challenge

et al. 2008

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Background-Inflammation is important to vascular repair following injury, modulating neointimal proliferation and remodeling. Previously, we have shown that a low-intensity inflammatory response aggravates neointimal formation following balloon and stent injury. The present study examined whether modulation of the extent and timing of nonspecific inflammation mediates the local vascular response in an additive unidirectional or rather a bidirectional fashion.Methods and results-Rabbits subjected to denudation and balloon injury of the iliac artery were treated with low(1 µg/kg) or high (100µg/kg) doses of bacterial endotoxin (LPS) immediately after injury, or with early high-dose LPS administered 3 days prior to injury (preconditioning). Neointimal formation at 28 days was significantly increased in the low-dose group (0.537 ± 0.059mm 2 ) as compared with controls (0.3 ± 0.03mm 2 ). High-dose LPS did not significantly affect neointimal formation while early high dose significantly reduced neointima (0.296 ± 0.033 and 0.194 ± 0.025mm 2 , respectively, n = 12-14/group). Arterial wall and systemically circulating interleukin-1β levels, and monocyte CD14 activation correlated with neointimal formation. Vascular remodeling was accelerated in animals treated with low-or high-dose LPS while not affected in the preconditioned group. Remodeling index inversely correlated with arterial matrix metalloproteinase-2 levels 6 days after injury.Conclusions-The extent and timing of nonspecific inflammation that is concurrent with vascular injury can determine different and opposite vascular repair patterns.

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Section: Discussionsupporting

confidence: 89%

Innate immunity has a dual effect on vascular healing: Suppression and aggravation of neointimal formation and remodeling post-endotoxin challenge

et al. 2008

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“…These findings supported the hypothesis that DES do not reduce stent restenosis by systemicanti inflammatory effects and that had been supported by some trials before [7,8,13,14] . When the patient characteristics in our BMS group were investigated, it was noted that there were more diabetics in this group.…”

Section: Discussionsupporting

confidence: 89%

“…In a trial including both stable CAD and acute coronary syndrome patients, J Heart Cardiol | Volume 1: Issue 3 www.ommegaonline.org Effects of Bare Metal and Drug Eluting Stents 47 34 patients had sirolimus stents and 29 patients had BMS. At the end of the trial CRP and IL-6 levels increased significantly in both stent groups, but the difference between the groups was not significant [7] . The trial done by Kim et al concluded different results about the DES and systemic inflammation.…”

Section: Discussionmentioning

confidence: 77%

“…Those were the first clinical data suggesting the possible beneficial effects of DES on systemic inflammation [6] . However, there were trials showing no significant CRP level difference between DES and BMS groups [7,8] . In addition to those trials done with first generation DES like sirolimus and paclitaxel, in 2014 a new trial with new generation DES, everolimus, was published.…”

Section: Comparison Of the Effects Of Bare Metal Stents And Drugmentioning

confidence: 98%

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Comparison of the Effects of Bare Metal Stents and Drug Eluting Stents on C- Reactive Protein Levels

Özyüncü¹

2015

JHC

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Aim: It's suggested that drug eluting stents (DES) may have systemic anti inflammatory properties and this can play a role in decreased restenosis rates. We aimed to compare bare metal stents (BMS) and DES on their effects on C-reactive protein (CRP) levels, a good marker of systemic inflammation. We also aimed to investigate the relation between the inflammation levels and myonecrosis and adverse cardiac events. Methods: Patients undergoing elective stent implantation were grouped as BMS (n = 70) and DES (n = 42). Basal and 24th hour postprocedural CRP and CKMB levels were measured and the difference (Δ) was compared between the groups. The patients were followed up for adverse cardiac events for one year. Results: Mean age was 62 ± 11 and 75% were males. There was significant CRP rise in both groups at 24 th hour, but the ΔCRP was 2.1 (0.5-6.2) mg/L in BMS and 2.3 (0.2-5.2) mg/L in DES group, the difference wasn't statistically significant (p = 0.703). ΔCKMB and adverse cardiac event rates were similar between the two groups (p = 0.897 and p = 0.785). There was no correlation between ΔCRP and ΔCKMB (r = -0.090 and p = 0.459 for BMS, r = 0.158 and p = 0.318 for DES). The effect of ΔCRP on the incidence of adverse cardiac events was not significant (p = 0.349 for BMS, p = 0.135 for DES). Conclusion: Our findings reveal that patients with BMS and DES implantation exhibit similar grade of systemic inflammation after the procedure. At similar levels of systemic inflammation, the local anti-inflammatory properties of DES can play a role at decreased restenosis rates.

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“…Putative differences in terms of early systemic inflammatory response among patients treated with DES versus BMS have been put forward as a plausible explanation for the DES superiority. Literature associates DES either with a decrease [14,15] or no effect [16,17] in the early systemic inflammatory response compared to BMS. The reasons for these unclear results are unknown, but the same limitations as described above for BMS may apply for DES.…”

mentioning

confidence: 99%

Early Systemic Inflammatory Response to Drug-Eluting Stents Implantation: The Heart of the Difference?

Pires

Jukema

2008

Cardiovasc Drugs Ther

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Systemic Inflammation After Drug-Eluting Stent Placement

Abstract: The inflammatory response to PCI appears similar in those treated with DES and BMS. Accordingly, the reduction in restenosis after DES is likely not mediated by attenuation of the systemic markers CRP, IL-1Ra, or IL-6.

Cited by 33 publications

References 21 publications

Innate immunity has a dual effect on vascular healing: Suppression and aggravation of neointimal formation and remodeling post-endotoxin challenge

Innate immunity has a dual effect on vascular healing: Suppression and aggravation of neointimal formation and remodeling post-endotoxin challenge

Comparison of the Effects of Bare Metal Stents and Drug Eluting Stents on C- Reactive Protein Levels

Early Systemic Inflammatory Response to Drug-Eluting Stents Implantation: The Heart of the Difference?

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