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ȣ - 490039 201 |
| The Effect of Granulocyte-Colony Stimulating Factor on In-Stent Restenosis in Porcine Model: Bare vs. drug-eluting stents |
| 전남대학교병원 순환기내과 |
| 임상엽, 안영근, 정명호, 김용숙, 주수연, 홍문화, 김정하, 이상록, 김계훈, 손일석, 홍영준, 박형욱, 김주한, 김원, 조정관, 박종춘, 강정채 |
Background: Stem cell mobilization using granulocyte colony-stimulating factor (G-CSF) to the infarcted heart showed improved cardiac function in many studies. But, with use of G-CSF, aggravation of in-stent restenosis (ISR) may occur and could be a serious problem. The purpose of this study was to characterize the effects of G-CSF on ISR model in porcine coronary arteries. Methods: Twenty bare stents (3*18 mm) were implanted in 20 porcine coronary arteries (Stents without G-CSF: Group I, Stents with G-CSF: Group II, n=10 in each group). G-CSF (10 µg/kg/day, once a day) was injected subcutaneously for 7 days from 24h after stent implantation. Complete blood count (CBC) with differentical count was checked before and 3 days after G-CSF injection. Twenty eight days after stenting, pigs were sacrificed after quantitative coronary angiography (QCA) and intravascular ultrasound (IVUS) analysis of coronay arteries. The coronaries were perfusion-fixed and stained, and pathologic examination was performed by computer-aided histomorphometry. Results: The findings of initial CBC were not different significantly between the two groups, but 3 days after G-CSF injection, white blood cell and monocyte count were significantly higher in Group II (7,950±1,523/mm3 vs. 24,672±1,087/mm3 and 282±37/mm3 vs. 2,505±338/mm3, p<0.001 in each). The minimal luminal diameter at 28 days was larger in Group I than that in Group II according to IVUS anlysis (3.2±0.58 mm vs. 2.1±0.06 mm, p<0.001). The neointimal area at 28 days was significantly smaller in Group I than that in Group II (3.1±0.99 mm2 vs. 13.0±3.75 mm2, p<0.001). The area stenosis was significantly lower in Group I than that in Group II (27.9±9.55 % vs. 76.7±12.01 %, p <0.001). The ratio of inflammatory cells out of the number of total cells in the neointima was 6.5±1.69 % in Group I and 10.1±6.33 % in Group II at 28 days (p<0.001). Conclusion: Stem cell mobilization using G-CSF aggravates ISR by local inflammatory cell infiltration. The results of drug eluting stents compared with bare stents and the underlying mechanism will be presented in Autumn meeting.
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