Arquivos Brasileiros de Cardiologia (Sep 2005)
Marcadores inflamatórios intracoronarianos após intervenções coronarianas percutâneas Intracoronary inflammatory markers after percutaneous coronary interventions
Abstract
OBJETIVO: Analisar a liberação intracoronariana de marcadores inflamatórios (MI) após intervenções coronarianas percutâneas (ICP) e comparar suas concentrações com relação ao tipo de ICP utilizada (rotablator vs angioplastia por balão). MÉTODOS: Foram randomizados 22 pacientes com média de idade de 60±11,9 anos, 12 do sexo masculino, portadores de síndromes coronarianas estáveis, submetidos ao tratamento eletivo de uma única lesão coronariana utilizando rotablator (N=11) ou pré-dilatação por balão (N=11) para implante de stents. As amostras foram colhidas na raiz da aorta e no seio coronariano, imediatamente antes e 15 minutos após as intervenções. Todas as dosagens foram feitas antes do implante do stent, sendo analisadas as citocinas TNF-a, IL-6 e IL-1 e as moléculas de adesão solúveis ICAM-1, E-selectina e P-selectina, utilizando o método ELISA. RESULTADOS: As concentrações de TNF-a e IL-6 aumentaram após as ICP, passando respectivamente de 9,5±1,5 pg/ml para 9,9±1,8 pg/ml (p=0,017) e de 6,0±2,4 pg/ml para 6,9±3,0 pg/ml (pOBJECTIVE: To analyze intracoronary release of inflammatory markers (IM) after percutaneous coronary interventions (PCI) and compare their concentrations concerning the type of PCI used (rotablator vs. balloon angioplasty). METHODS: Twenty-two patients with average age of 60±11.9 years old, 12 of male sex, with stable coronary disease, submitted to elective treatment of a single coronary lesion, using rotablator (N=11) or balloon pre-dilatation (N=11) for stent implant were randomized. Samples were collected at aorta root and coronary sinus, immediately before and 15 minutes after intervention. All dosages were made before stent implant, and the cytokines TNF-a, IL-6 and IL-1 and the soluble adhesion molecules ICAM-1, E-selectin and P-selectin were analyzed by using ELISA method. RESULTS: TNF-a and IL-6 concentrations increased after PCI, respectively from 9.5±1.5 pg/ml to 9.9±1.8 pg/ml (p=0.017) and from 6.0±2.4 pg/ml to 6.9±3.0 pg/ml (p<0.001). There was no significant changes in IL-1, ICAM-1 and P-selectin, and a decrease in E-selectin concentrations after the procedures (52.0±17.5 ng/ml to 49.3±18.7 ng/ml; p=0.009) was observed. There were no significant differences between IM concentrations after PCI, concerning the type of procedure used. CONCLUSION: At the early period, post-percutaneous coronary interventions, an increase of intracoronary concentrations of TNF-a and IL-6, and absence of significant difference between concentrations of inflammatory markers released in coronary flow through rotablator and balloon angioplasty were observed.
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