Sardella Gennaro, Mariani Paola, D'Alessandro Mariadomenica, De Luca Leonardo, Pierro Marianna, Mancone Massimo, Porretta Alessandro, Accapezzato Daniele, Fedele Francesco, Paroli Marino
Dipartimento di Scienze Cardiovascolari e Respiratorie, Università La Sapienza, Viale del Policlinico 155, 00161, Rome, Italy.
Thromb Res. 2006;117(6):659-64. doi: 10.1016/j.thromres.2005.06.002. Epub 2005 Jul 11.
Drug-eluting stent (DES) implantation represents an important innovation in the treatment of coronary artery disease. However, inflammatory-related complications, including subacute thrombosis and in-stent restenosis, are still important limitations to percutaneous coronary intervention (PCI). The aim of this study was to compare early local release of interleukin 1beta (IL-1beta) and IL-6 proinflammatory cytokines after elective placement of either bare metal stents or DES.
IL-1beta and IL-6 levels were assayed in plasma obtained from the coronary sinus both before and 20 min after stent implantation in 59 patients with stable angina, who were randomly assigned to receive bare, paclitaxel-, or sirolimus-eluting stents during elective PCI.
We found that IL-1beta and IL-6 levels were significantly increased in the coronary sinus of patients receiving either bare, paclitaxel- or sirolimus-eluting stents 20 min after stent implantation as compared with basal concentrations. The variation in the level of both cytokines was comparable among the three study groups.
A local release of proinflammatory cytokines occurs shortly after coronary stent placement, including DES, which is possibly related to plaque rupture and/or endothelium traumatism following the stenting procedure. This suggests that precocious anti-inflammatory treatment could be of benefit to further improve the PCI clinical outcome.
药物洗脱支架(DES)植入是冠状动脉疾病治疗中的一项重要创新。然而,包括亚急性血栓形成和支架内再狭窄在内的炎症相关并发症仍是经皮冠状动脉介入治疗(PCI)的重要局限性。本研究的目的是比较裸金属支架或DES选择性置入后白细胞介素1β(IL-1β)和IL-6促炎细胞因子的早期局部释放情况。
对59例稳定型心绞痛患者在支架植入前及植入后20分钟从冠状窦采集的血浆中IL-1β和IL-6水平进行检测,这些患者在择期PCI期间被随机分配接受裸支架、紫杉醇洗脱支架或西罗莫司洗脱支架。
我们发现,与基础浓度相比,接受裸支架、紫杉醇洗脱支架或西罗莫司洗脱支架的患者在支架植入后20分钟冠状窦内IL-1β和IL-6水平显著升高。三个研究组中两种细胞因子水平的变化相当。
冠状动脉支架置入后不久,包括DES,会出现促炎细胞因子的局部释放,这可能与支架置入术后斑块破裂和/或内皮损伤有关。这表明早期抗炎治疗可能有助于进一步改善PCI的临床结果。