Background: After coronary artery stenting, inflammatory mechanisms play a crucial role the pathogenesis of neointimal proliferation and in-stent restenosis. Drug eluting stents(DES) with anti-inflammatory and anti-proliferative properties had been shown to reduce neointimal hyperplasia effectively in animal and clinical studies. However, few data regarding anti-inflammatory effects of DES in clinical studies are currently available. Therefore, we investigated plasma levels of high sensitivity C-reactive protein(hsCRP) after DES insertion and compared with those after bare metal stent(BMS) implantation. Methods: In a prospective single center study, we performed percutaneous coronary intervention(PCI) with single stent in 67 patients with clinically stable angina. There were 21 patients in the BMS group and 46 patients in DES(Cypher® n=29, Taxus® n=17). Plasma levels of hsCRP were determined before intervention and 48 hours, 72 hours and 2 weeks after coronary stenting. Results: There were 54 men(80.6%) and the age of patients ranged from 37 to 75 years(mean, 59 ± 9 years). There was no difference in age, frequency of DM, lipid profile, stent length, frequency of statin medication and initial hsCRP level. However, DM was more frequently in DES group(34.8 % vs. 9.5 %, p = 0.04) and the stent diameter was larger in BMS group(3.4 ± 0.5 mm vs. 3.0 ±0.4 mm, p < 0.01). The plasma levels of hsCRP at 48 hours(13.4 ± 14.7 vs. 5.9 ± 4.9 mg/L, p < 0.01) and 72 hours(16.7 ± 19.8 vs. 5.4 ± 3.9 mg/L, p < 0.01) after coronary stenting were significantly higher in BMS group than DES group. Between sirolimus-eluting stent and paclitaxel-eluting stent, there was no significant difference in hsCRP levels at 48 (6.0± 5.0 vs. 5.8 ± 5.0 mg/L) and 72 hours(4.8 ± 3.2 vs. 6.0 ± 4.7 mg/L). The hsCRP levels decreased to 2.5 mg/L ± 3.0 mg/L in BMS group and 1.5 ± 2.8 mg/L in DES group at 2 weeks after coronary intervention, which showed no statistical difference(p = 0.2). Conclusion: DES showed significantly reduced plasma hsCRP levels at 48 and 72 hours after coronary stenting compared to BMS. This may reflect potent effects of DES on inflammatory reactions induced by coronary stenting.
|
