Institute of Cardiology, Catholic University of the Sacred Heart, Rome, Italy.
Curr Vasc Pharmacol. 2013 Jul;11(4):392-8. doi: 10.2174/1570161111311040003.
In-stent restenosis and stent thrombosis represent the main adverse reactions to coronary stents and individual susceptibility appears to play an important role in their onset. In particular, inflammatory status, classically assessed by C-reactive protein levels, predicts the risk of in-stent restenosis after bare-metal stent implantation but not after drug-eluting stent (DES) implantation. On the other hand, C-reactive protein seems to predict the risk of stent thrombosis after treatment with DES but not with bare-metal stent. If DES have considerably reduced, as compared to bare-metal stent, the rate of adverse reaction in the first year after implantation, concern is emerging about late events that seem to be related to delayed healing and allergic reactions to polymers, a process in which eosinophils play an important role by enhancing restenosis and thrombosis.
支架内再狭窄和支架内血栓形成是冠状动脉支架的主要不良反应，个体易感性似乎在其发病中起着重要作用。特别是，炎症状态，经典地通过 C 反应蛋白水平来评估，预测裸金属支架植入后的支架内再狭窄风险，但不预测药物洗脱支架 (DES) 植入后的风险。另一方面，C 反应蛋白似乎预测 DES 治疗后支架内血栓形成的风险，但不预测裸金属支架治疗后的风险。如果 DES 与裸金属支架相比，在植入后第一年的不良反应发生率显著降低，那么人们开始关注似乎与延迟愈合和对聚合物的过敏反应相关的晚期事件，这一过程中嗜酸性粒细胞通过促进再狭窄和血栓形成起着重要作用。
