The inflammatory response to percutaneous coronary intervention is related to the technique of stenting and not the type of stent

Abstract

Introduction: Several studies have demonstrated that percutaneous coronary intervention (PCI) induces the release of multiple inflammatory markers which is associated with a later poor prognosis. We aimed to evaluate the inflammatory response to PCI via the assessment of the pre- and post-PCI serum levels of high-sensitive C-reactive protein (hsCRP), interleukin (IL)-6, and intercellular adhesion molecule (ICAM)-1 in relation to the technique of stenting (predilation versus direct stenting [DS]), the type of stent (bare-metal [BMS] versus drug-eluting stents [DES]), the various coronary lesion characteristics, and the other PCI procedural variables. Methods: We studied 75 consecutive patients (aged 54.2 ± 9.1 years, 54 men) enrolled between March and September 2012. BMS and DES were deployed in 46 and 29 patients respectively; via predilation technique in 37 patients and DS technique in 38 patients. Patients were evaluated monthly in the cardiology outpatient clinic for 6 months. Results: The procedural increase in hsCRP and ICAM-1 was statistically significant in high risk coronary lesions (total occlusions, bifurcation lesions, and in-stent restenosis). The PCI-induced change of mean hsCRP, IL-6, and ICAM-1 levels was statistically significant in relation to the technique of stenting (predilation leads to augmented inflammatory response compared to DS) but was unrelated to the type of stent (BMS or DES). Conclusions: Predilation significantly augments the inflammatory response to PCI than DS irrespective of the type of stent (BMS or DES). So, if predilation is required before any type of stent, measures to improve the patient’s inflammatory profile should be carried out in advance.

Keywords

• Angioplasty
• Coronary
• C-reactive protein
• Interleukin-6
• Intercellular adhesion molecule-1
• Predilation