Permanent polymer of drug eluting stents increases eosinophil cationic protein levels following percutaneous coronary intervention independently of C-reactive protein

Atherosclerosis. 2014 Dec;237(2):816-20. doi: 10.1016/j.atherosclerosis.2014.11.002. Epub 2014 Nov 6.

Abstract

Aim: To assess eosinophil cationic protein (ECP) and C-reactive protein (CRP) serum levels at three time points according to different stent types.

Methods: 54 patients (age 64 ± 10 years, male 78%), undergoing Bare Metal Stent (BMS) (n = 11), mammalian Target Of Rapamycin (mTOR)-inhibitor DES (n = 27) and mTOR-inhibitor bioabsorbable DES (BES) (n = 16) implantation for stable angina (SA) or non-ST-elevation acute coronary syndromes (NSTE-ACS), were prospectively enrolled. ECP and CRP serum levels were assessed before revascularization, at 1-month and at 1-year after the procedure. Moreover, 21 patients found to have inducible ischemia or angina symptoms at 6 month-stress test underwent 1-year follow-up (FU) angiography.

Results: Baseline and 1-month ECP levels were similar among the 3 groups, whilst 1-year ECP was significantly higher in m-TOR-DES [8.61 (6.55-19.77) μg/ml] compared with m-TOR-BES [2.03 (1.78-5.53) μg/ml] and BMS-treated patients [2.23 (1.45-8.95) μg/ml] (p = 0.02), without significant difference between BES and BMS. CRP was similar among the 3 groups at all time points. 1-year ECP significantly correlated with late loss in patients undergoing FU angiography (r = 0.64, p = 0.002), while CRP did not (p = NS).

Conclusions: Our finding suggests that mTOR-DES stent type is associated with an increase of ECP levels at 1-year, possibly reflecting a persistent eosinophil activation triggered by permanent polymer.

Keywords: Bare metal stent or drug-eluting stent; ECP; Inflammatory markers; Permanent polymer.

MeSH terms

  • Aged
  • Angina, Stable / metabolism
  • Angiography
  • Biocompatible Materials / chemistry
  • Biomarkers / metabolism
  • C-Reactive Protein / biosynthesis
  • Drug-Eluting Stents*
  • Eosinophil Cationic Protein / blood*
  • Female
  • Humans
  • Inflammation
  • Male
  • Metals / chemistry
  • Middle Aged
  • Myocardial Ischemia / pathology
  • Percutaneous Coronary Intervention*
  • Polymers / chemistry*
  • Prospective Studies
  • Stents
  • TOR Serine-Threonine Kinases / metabolism

Substances

  • Biocompatible Materials
  • Biomarkers
  • Metals
  • Polymers
  • C-Reactive Protein
  • MTOR protein, human
  • TOR Serine-Threonine Kinases
  • Eosinophil Cationic Protein