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Erschienen in: Heart and Vessels 2/2014

01.03.2014 | Original Article

The late-phase inflammatory response after drug-eluting stent implantation

verfasst von: Isao Taguchi, Shuichi Yoneda, Shichiro Abe, Shigeru Toyoda, Takahisa Nasuno, Setsu Nishino, Michiya Kageyama, Michiaki Tokura, Mikie Ogawa, Koichi Node, Teruo Inoue

Erschienen in: Heart and Vessels | Ausgabe 2/2014

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Abstract

Recent advances in drug-eluting stent (DES) technology have succeeded in preventing restenosis. In addition to inhibiting smooth muscle cell proliferation, DES greatly inhibits the local inflammatory response in the acute phase after implantation, leading to prevention of restenosis. However, a unique issue in DES implantation is an impairment of reendothelialization, which may result in abnormal wound healing. Consequently, a late-phase inflammatory relapse could appear in the long term after DES implantation. In this study, we measured serum levels of inflammatory markers, including interleukin (IL)-6, IL-8, tumor necrosis factor-α, monocyte chemoattractant protein-1, matrix metalloproteinase-9, and myeloperoxidase, as well as high-sensitivity C-reactive protein at follow-up coronary angiography (mean 9 months) in 54 patients who received DES stenting who did not experience restenosis, and compared them with 51 patients receiving bare-metal stents (BMS) without restenosis. The level of IL-6 was over the measurement threshold (≥2.22 pg/ml) in 12 patients (21 %) in the DES group, but in only 2 patients (4 %) in the BMS group (P = 0.003). IL-8 was significantly higher in the DES group than in the BMS group (4.51 ± 2.40 vs 3.84 ± 1.34 pg/ml, P = 0.015). The levels of other biomarkers were similar between the two groups. DES showed an increase in inflammatory cytokines in the late phase after implantation in comparison with patients who received BMS, suggesting late-stage inflammation. Therefore, the wound-healing response after DES implantation might be different from that after BMS.
Literatur
1.
Zurück zum Zitat Poon M, Marx SO, Gallo R, Badimon JJ, Taubman MB, Marks AR (1996) Rapamycin inhibits vascular smooth muscle cell migration. J Clin Invest 98:2277–2283PubMedCentralPubMedCrossRef Poon M, Marx SO, Gallo R, Badimon JJ, Taubman MB, Marks AR (1996) Rapamycin inhibits vascular smooth muscle cell migration. J Clin Invest 98:2277–2283PubMedCentralPubMedCrossRef
2.
Zurück zum Zitat Costa M, Simon D (2005) Molecular basis of restenosis and drug-eluting stents. Circulation 111:2257–2273PubMedCrossRef Costa M, Simon D (2005) Molecular basis of restenosis and drug-eluting stents. Circulation 111:2257–2273PubMedCrossRef
3.
Zurück zum Zitat Inoue T, Node K (2009) Molecular basis of restenosis and novel issues of drug-eluting stents. Circ J 73:615–621PubMedCrossRef Inoue T, Node K (2009) Molecular basis of restenosis and novel issues of drug-eluting stents. Circ J 73:615–621PubMedCrossRef
4.
Zurück zum Zitat Inoue T, Croce K, Morooka T, Sakuma M, Node K, Simon DI (2011) Vascular inflammation and repair: implication for reendothelialization, restenosis, and stent thrombosis. J Am Coll Cardiol Interv 4:1057–1066CrossRef Inoue T, Croce K, Morooka T, Sakuma M, Node K, Simon DI (2011) Vascular inflammation and repair: implication for reendothelialization, restenosis, and stent thrombosis. J Am Coll Cardiol Interv 4:1057–1066CrossRef
5.
Zurück zum Zitat Suzuki T, Kopia G, Hayashi S, Bailey L, Llanos G, Wilensky R, Klugherz B, Papandreou G, Narayan P, Leon M, Yeung A, Tio F, Tsao P, Falotico R, Carter A (2001) Stent-based delivery of sirolimus reduces neointimal formation in a porcine coronary model. Circulation 104:1188–1193PubMedCrossRef Suzuki T, Kopia G, Hayashi S, Bailey L, Llanos G, Wilensky R, Klugherz B, Papandreou G, Narayan P, Leon M, Yeung A, Tio F, Tsao P, Falotico R, Carter A (2001) Stent-based delivery of sirolimus reduces neointimal formation in a porcine coronary model. Circulation 104:1188–1193PubMedCrossRef
6.
Zurück zum Zitat Webster MW, Ormiston JA (2007) Drug-eluting stents and late stent thrombosis. Lancet 370:914–915PubMedCrossRef Webster MW, Ormiston JA (2007) Drug-eluting stents and late stent thrombosis. Lancet 370:914–915PubMedCrossRef
7.
Zurück zum Zitat Virmani R, Guagliumi G, Farb A, Musumeci G, Grieco N, Motta T, Mihalcsik L, Tespili M, Valsecchi O, Kolodgie FD (2004) Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation 109:701–705PubMedCrossRef Virmani R, Guagliumi G, Farb A, Musumeci G, Grieco N, Motta T, Mihalcsik L, Tespili M, Valsecchi O, Kolodgie FD (2004) Localized hypersensitivity and late coronary thrombosis secondary to a sirolimus-eluting stent: should we be cautious? Circulation 109:701–705PubMedCrossRef
8.
Zurück zum Zitat Rifai N, Tracy RP, Ridker PM (1999) Clinical efficacy of an automated high-sensitivity C-reactive protein assay. Clin Chem 45:2136–2141PubMed Rifai N, Tracy RP, Ridker PM (1999) Clinical efficacy of an automated high-sensitivity C-reactive protein assay. Clin Chem 45:2136–2141PubMed
9.
Zurück zum Zitat Carson RT, Vignali DA (1999) Simultaneous quantitation of 15 cytokines using a multiplexed flow cytometric assay. J Immunol Methods 227:41–52PubMedCrossRef Carson RT, Vignali DA (1999) Simultaneous quantitation of 15 cytokines using a multiplexed flow cytometric assay. J Immunol Methods 227:41–52PubMedCrossRef
10.
Zurück zum Zitat de Jager W, te Velthuis H, Prakken BJ, Kuis W, Rijkers GT (2003) Simultaneous detection of 15 human cytokines in a single sample of stimulated peripheral blood mononuclear cells. Clin Diagn Lab Immunol 10:133–139PubMedCentralPubMed de Jager W, te Velthuis H, Prakken BJ, Kuis W, Rijkers GT (2003) Simultaneous detection of 15 human cytokines in a single sample of stimulated peripheral blood mononuclear cells. Clin Diagn Lab Immunol 10:133–139PubMedCentralPubMed
11.
Zurück zum Zitat Inoue T, Sata M, Hikichi Y, Sohma R, Fukuda D, Uchida T, Shimizu M, Komoda H, Node K (2007) Mobilization of CD34-positive bone marrow-derived cells after coronary stent implantation: impact on restenosis. Circulation 115:553–561PubMedCrossRef Inoue T, Sata M, Hikichi Y, Sohma R, Fukuda D, Uchida T, Shimizu M, Komoda H, Node K (2007) Mobilization of CD34-positive bone marrow-derived cells after coronary stent implantation: impact on restenosis. Circulation 115:553–561PubMedCrossRef
12.
Zurück zum Zitat Finn AV, Kolodgie FD, Harnek J, Guerrero LJ, Acampado E, Tefera K, Skorija K, Weber DK, Gold HK, Virmani R (2005) Differential response of delayed healing and persistent inflammation at sites of overlapping sirolimus- or paclitaxel-eluting stents. Circulation 112:270–278PubMedCrossRef Finn AV, Kolodgie FD, Harnek J, Guerrero LJ, Acampado E, Tefera K, Skorija K, Weber DK, Gold HK, Virmani R (2005) Differential response of delayed healing and persistent inflammation at sites of overlapping sirolimus- or paclitaxel-eluting stents. Circulation 112:270–278PubMedCrossRef
13.
Zurück zum Zitat Joner M, Finn AV, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R (2006) Pathology of drug-eluting stent in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:203–205CrossRef Joner M, Finn AV, Mont EK, Kolodgie FD, Ladich E, Kutys R, Skorija K, Gold HK, Virmani R (2006) Pathology of drug-eluting stent in humans: delayed healing and late thrombotic risk. J Am Coll Cardiol 48:203–205CrossRef
14.
Zurück zum Zitat Watanabe Y, Asano R, Hata N, Inoue K, Takamisawa H, Seki A, Aikawa M, Tobaru T, MIsu K, Iguchi N, Nagayama M, Watanabe H, Takayama M, Umemura J, Sumiyoshi T (2009) Late stent malapposition with marked positive vascular remodeling observed only at the site of drug-eluting stents after multivessel coronary stenting. Heart Vessels 24:308–312PubMedCrossRef Watanabe Y, Asano R, Hata N, Inoue K, Takamisawa H, Seki A, Aikawa M, Tobaru T, MIsu K, Iguchi N, Nagayama M, Watanabe H, Takayama M, Umemura J, Sumiyoshi T (2009) Late stent malapposition with marked positive vascular remodeling observed only at the site of drug-eluting stents after multivessel coronary stenting. Heart Vessels 24:308–312PubMedCrossRef
15.
Zurück zum Zitat Abe S, Yoneda S, Kanaya T, Oda K, Nishino S, Kageyama M, Taguchi I, Masawa N, Inoue T (2012) Pathological features of in-stent restenosis after sirolimus-eluting stent vs. bare metal stent placement. Cardiovasc Pathol 21:e19–e22PubMedCrossRef Abe S, Yoneda S, Kanaya T, Oda K, Nishino S, Kageyama M, Taguchi I, Masawa N, Inoue T (2012) Pathological features of in-stent restenosis after sirolimus-eluting stent vs. bare metal stent placement. Cardiovasc Pathol 21:e19–e22PubMedCrossRef
16.
Zurück zum Zitat Yoneda S, Abe S, Kanaya T, Oda K, Nishino S, Kageyama M, Taguchi I, Masawa N, Inoue T (2013) Late phase inflammatory response as a feature of in-stent restenosis after drug-eluting stent implantation. Coronary Artery Dis (in press) Yoneda S, Abe S, Kanaya T, Oda K, Nishino S, Kageyama M, Taguchi I, Masawa N, Inoue T (2013) Late phase inflammatory response as a feature of in-stent restenosis after drug-eluting stent implantation. Coronary Artery Dis (in press)
17.
Zurück zum Zitat Otsuka Y, Nakamura M, Kokubu N, Tonooka N, Inoue K, Higami T (2012) Diffuse in-stent restenosis of CYPHER® stent due to hypersensitivity reaction confirmed by pathohistological findings. Heart Vessels 27:110–113PubMedCrossRef Otsuka Y, Nakamura M, Kokubu N, Tonooka N, Inoue K, Higami T (2012) Diffuse in-stent restenosis of CYPHER® stent due to hypersensitivity reaction confirmed by pathohistological findings. Heart Vessels 27:110–113PubMedCrossRef
18.
Zurück zum Zitat Yano H, Horinaka S, Yagi H, Ishimitsu T (2013) Comparison of inflammatory response after implantation of sirolimus- and paclitaxel-eluting stents in patients on hemodialysis. Heart Vessels. doi:10.1007/s00380-012-0250-9 Yano H, Horinaka S, Yagi H, Ishimitsu T (2013) Comparison of inflammatory response after implantation of sirolimus- and paclitaxel-eluting stents in patients on hemodialysis. Heart Vessels. doi:10.​1007/​s00380-012-0250-9
19.
Zurück zum Zitat Yoneda S, Abe S, Taguchi I, Masawa N, Inoue K, Inoue T (2012) Inflammation and impaired wound healing after zotarolimus-eluting stent implantation. Cardiovasc Pathol 21:511–514 Yoneda S, Abe S, Taguchi I, Masawa N, Inoue K, Inoue T (2012) Inflammation and impaired wound healing after zotarolimus-eluting stent implantation. Cardiovasc Pathol 21:511–514
20.
Zurück zum Zitat Castell JV, Gomez-Lechon MJ, David M, Hirano T, Kishimoto T, Heinrich PC (1988) Recombinant human interleukin-6 (IL-6/BSF-2/HSF) regulates the synthesis of acute phase proteins in human hepatocytes. FEBS Lett 232:347–350PubMedCrossRef Castell JV, Gomez-Lechon MJ, David M, Hirano T, Kishimoto T, Heinrich PC (1988) Recombinant human interleukin-6 (IL-6/BSF-2/HSF) regulates the synthesis of acute phase proteins in human hepatocytes. FEBS Lett 232:347–350PubMedCrossRef
21.
Zurück zum Zitat Lindmark E, Diderholm E, Wallentin L, Siegbahn A (2001) Relationship between interleukin 6 and mortality in patients with unstable coronary artery disease: effects of an early invasive or noninvasive strategy. JAMA 286:2107–2113PubMedCrossRef Lindmark E, Diderholm E, Wallentin L, Siegbahn A (2001) Relationship between interleukin 6 and mortality in patients with unstable coronary artery disease: effects of an early invasive or noninvasive strategy. JAMA 286:2107–2113PubMedCrossRef
22.
Zurück zum Zitat Woodward M, Rumley A, Welsh P, Macmahon S, Lowe GD (2007) A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease. J Thromb Haemost 5:1795–1800PubMedCrossRef Woodward M, Rumley A, Welsh P, Macmahon S, Lowe GD (2007) A comparison of the associations between seven hemostatic or inflammatory variables and coronary heart disease. J Thromb Haemost 5:1795–1800PubMedCrossRef
23.
Zurück zum Zitat Yue TL, Wang X, Sung CP, Olson B, McKenna PJ, Gu JL, Feuerstein GZ (1994) Interleukin-8, a mitogen and chemoattractant for vascular smooth muscle cells. Circ Res 75:1–7PubMedCrossRef Yue TL, Wang X, Sung CP, Olson B, McKenna PJ, Gu JL, Feuerstein GZ (1994) Interleukin-8, a mitogen and chemoattractant for vascular smooth muscle cells. Circ Res 75:1–7PubMedCrossRef
24.
Zurück zum Zitat Inoue T, Komoda H, Nonaka M, Kameda M, Uchida T, Node K (2008) Interleukin-8 as an independent predictor of long-term clinical outcome in patients with coronary artery disease. Int J Cardiol 124:319–325PubMedCrossRef Inoue T, Komoda H, Nonaka M, Kameda M, Uchida T, Node K (2008) Interleukin-8 as an independent predictor of long-term clinical outcome in patients with coronary artery disease. Int J Cardiol 124:319–325PubMedCrossRef
25.
Zurück zum Zitat Rattazzi M, Puato M, Faggin E, Bertipaglia B, Zambon A, Pauletto P (2003) C-reactive protein and interleukin-6 in vascular disease: culprits or passive bystanders? J Hypertens 21:1787–1803PubMedCrossRef Rattazzi M, Puato M, Faggin E, Bertipaglia B, Zambon A, Pauletto P (2003) C-reactive protein and interleukin-6 in vascular disease: culprits or passive bystanders? J Hypertens 21:1787–1803PubMedCrossRef
26.
Zurück zum Zitat Jug B, Salobir BG, Vene N, Šebeštjen M, Šabovič M, Keber I (2009) Interleukin-6 is a stronger prognostic predictor than high-sensitive C-reactive protein in patients with chronic stable heart failure. Heart Vessels 24:271–276PubMedCrossRef Jug B, Salobir BG, Vene N, Šebeštjen M, Šabovič M, Keber I (2009) Interleukin-6 is a stronger prognostic predictor than high-sensitive C-reactive protein in patients with chronic stable heart failure. Heart Vessels 24:271–276PubMedCrossRef
Metadaten
Titel
The late-phase inflammatory response after drug-eluting stent implantation
verfasst von
Isao Taguchi
Shuichi Yoneda
Shichiro Abe
Shigeru Toyoda
Takahisa Nasuno
Setsu Nishino
Michiya Kageyama
Michiaki Tokura
Mikie Ogawa
Koichi Node
Teruo Inoue
Publikationsdatum
01.03.2014
Verlag
Springer Japan
Erschienen in
Heart and Vessels / Ausgabe 2/2014
Print ISSN: 0910-8327
Elektronische ISSN: 1615-2573
DOI
https://doi.org/10.1007/s00380-013-0357-7

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