The Role Of Inflammation In Stent Restenosis More Than 1 Year Afetr Drug Eluting Stent Implantation

In stent restenosis (ISR) following endovascular interventions is the main limitation of their long-term success. Despite advances have been made during recent years to decrease restenosis, it remains a challenging clinical problem.The aim of this study was to evaluate the relationship between angiographic coronary in stent restenosis, inflammation after successful stent implantation.

This study included 78 patients, 35year old and higher who underwent coronary angiography more than 1 year after drug-eluting stent (DES) implantation because of symptoms suggestive ischemia. Patients were divided into ISR group (case) and patent stent group (control) according to angiography results. For all patients blood lipids and high sensitivity C-Reactive Protein (hsCRP) were measured simultaneously.

Age, sex, hypertension, current smoking, and lipid profile other than High Density Lipoprotein (HDL-C) of patients in the case and control groups were similar. However, HDL-C < 40mg/L was more prevalent with ISR (66.7% vs. 30.8%, p=0.002). The hsCRP level was 2.98±2.06 mg/L in the case group and 2.50±1.80 mg/L in the control group. There were no significant differences in mean hsCRP concentration between the two groups (p=0.14), however mean hsCRP level was significantly higher in men of case group than control group (3.35mg/L vs. 2.21mg/L, p<0.05).

This study demonstrates that in men but not in women inflammation may be a predictor of in stent restenosis more than 1 year after drug eluting stent implantation. Also, high-density lipoprotein (HDL) probably has protective effect against stent restenosis.