Caixeta Adriano M, Brito Fábio S, Costa Marco A, Serrano Carlos V, Petriz João L, Da Luz Protásio L
Division of Interventional Cardiology, Brasília Heart Institute (InCor-DF), Zerbini Foundation, Estrada Parque Contorno do Bosque, s/n Parte, CEP:70658-900 Brasília, DF, Brazil.
Catheter Cardiovasc Interv. 2007 Mar 1;69(4):500-7. doi: 10.1002/ccd.21007.
The aims of this study were to investigate the effect of coronary stenting on the release of cytokines and cell-mediated immunity factors and to evaluate the association between inflammation and clinical outcomes at 6 months.
Circulating levels of inflammatory markers and cytokines are elevated in patients with acute coronary syndromes and are related to an unfavorable outcome. The aims of this study were to investigate the effect of coronary stenting on the release of cytokines and cell-mediated immunity factors and to evaluate the association between inflammation and clinical outcomes at 6 months.
Forty patients with single native coronary artery disease treated with stenting were enrolled. Peripheral venous blood samples were collected before and 6 h, 48 h, and 12 weeks after stenting. Serum concentrations of high-sensitivity C-reactive protein, interleukin-6, interleukin-8, tumor necrosis factor-alpha (markers of inflammation) and serum-soluble interleukin-2 receptor for T-lymphocyte activation (sIL2-R, marker of cell-mediated immunity) were measured. Patients also were evaluated clinically one, 3, and 6 months post-stenting or when they presented with cardiovascular symptoms to identify major adverse cardiac events (cardiac death, MI, revascularization).
Concentrations of interleukins 6 and 8 and tumor necrosis factor-alpha peaked at 6 h (11.0, 12.6, and 5.3 pg/ml, respectively). The peak level of high-sensitivity C-reactive protein (2.77 mg/dL) occurred 48 h post stenting, while sIL2-R peaked (495 U/ml) at 12 weeks. Patients who experienced restenosis had higher levels of C-reactive protein at 48 h (4.94 vs. 1.84 mg/dl; P = 0.043) and of IL-8 at 6 h (26.75 vs. 13.55 pg/mL; P = 0.048) than those without restenosis.
Proinflammatory cytokines and inflammatory markers are released into the peripheral circulation early after coronary stenting, and increased levels of some are associated with clinically relevant restenosis.
本研究旨在探讨冠状动脉支架置入术对细胞因子释放及细胞介导免疫因子的影响，并评估炎症与6个月时临床结局之间的关联。
急性冠状动脉综合征患者循环中的炎症标志物和细胞因子水平升高，且与不良结局相关。本研究旨在探讨冠状动脉支架置入术对细胞因子释放及细胞介导免疫因子的影响，并评估炎症与6个月时临床结局之间的关联。
纳入40例接受支架置入术治疗的单支原位冠状动脉疾病患者。在支架置入术前、术后6小时、48小时和12周采集外周静脉血样本。检测血清高敏C反应蛋白、白细胞介素-6、白细胞介素-8、肿瘤坏死因子-α（炎症标志物）以及用于T淋巴细胞活化的血清可溶性白细胞介素-2受体（sIL2-R，细胞介导免疫标志物）的浓度。在支架置入术后1个月、3个月和6个月或患者出现心血管症状时对其进行临床评估，以确定主要不良心脏事件（心源性死亡、心肌梗死、血运重建）。
白细胞介素6、8以及肿瘤坏死因子-α的浓度在6小时时达到峰值（分别为11.0、12.6和5.3 pg/ml）。高敏C反应蛋白的峰值水平（2.77 mg/dL）出现在支架置入术后48小时，而sIL2-R在12周时达到峰值（495 U/ml）。发生再狭窄的患者在48小时时的C反应蛋白水平（4.94 vs. 1.84 mg/dl；P = 0.043）以及在6小时时的IL-8水平（26.75 vs. 13.55 pg/mL；P = 0.048）高于未发生再狭窄的患者。
促炎细胞因子和炎症标志物在冠状动脉支架置入术后早期释放到外周循环中，且某些因子水平升高与临床相关的再狭窄有关。
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