Influence of coronary angioplasty and stenting on inflammatory biomarkers in patients with stable coronary artery disease

Abstract

Target. The aim of our study was to study the effect of coronary angioplasty and stenting on inflammatory biomarkers in patients with stable coronary artery disease (CHD). Materials and methods. The study included 54 patients who were implanted with 78 drug-eluting stents (DES). In the patient's blood serum immediately before and 24 hours after stent implantation, the following was determined: C-reactive protein by a highly sensitive method (hsCRV), C3 complement component, fibrinogen, ferritin, homocysteine, as well as pro-inflammatory cytokines: tumor necrosis factor - alpha (TNF-α), interleukins (CL) (IL-1-α, IL-1-β, IL-6, IL-8) , endothelin-1 (ET-1) Results: The median hsCRP concentration after coronary angioplasty and stenting was significantly higher than the baseline level (2.26 (0.75-6.00) and 4.07 (2.14-6 , 13) p = 0.029, respectively, before and after stenting) Stent implantation led to an increase in the median fibrinogen concentration from 3.43 (2.89—4.11) to 3.65 (3.33—4.20), p = 0.035, and ferritin from 150.5 (71.8-233.0) to 199.2 (130.1-306.5), p = 0.016. f the concentration of the C3 component of the complement, homocysteine. C3 and homocysteine ​​levels did not change significantly after the procedure. Implantation of IE5 was not accompanied by changes in the concentrations of the studied cytokines (TNF-α, IL-1-α, IL-1-β, IL-8, endothelin-1), with the exception of IL-6 (2.38 (1.48-7, 12) and 6.64 (2.98-9.58) p = 0.007, respectively, before and after implantation). There was a strong positive correlation between IL-6 and hsCRP (r = 0.74, p = 0.01), indicating an increase in the level of acute phase protein in response to stimulation with an inflammatory cytokine after stenting. Conclusions. Coronary angioplasty and implantation of drug-eluting stents were accompanied by an increase in inflammatory biomarkers (hsCRP, IL-6, ferritin, fibrinogen). Determination of markers of the inflammatory response during DES implantation can be useful for identifying patients prone to a high risk of complications after myocardial revascularization, as well as for preventing ischemic events in the long term.