Original articles

Interventional cardiology

Comparison of inflammatory markers and angiographic outcomes after implantation of sirolimus and paclitaxel-eluting stents

W C Kang¹, T H Ahn¹, C I Moon¹, S H Han¹, E K Shin¹, J-S Kim², Y-G Ko², D Choi², Y Jang², B-K Kim³, S J Oh³, D W Jeon³, J-Y Yang³

¹ Division of Cardiology, Gachon University of Medicine and Science, Incheon, Korea
² Division of Cardiology, Yonsei University College of Medicine, Seoul, Korea
³ NHIC Ilsan Hospital, Koyang, Korea

Dr Woong Chol Kang, Cardiology, Gil Medical Center, Gachon University of Medicine and Science, 1198 Kuwol-dong, Namdong-gu, Incheon, Korea 405-760; kangwch{at}gilhospital.com

Objective: We compared the degree of systemic inflammation and its relation to the angiographic outcomes after drug-eluting stent (DES) implantations.

Methods: We implanted a single DES in 79 stable angina patients (50 men; 60.4 (9.5) years of age; sirolimus-eluting stent (SES), n = 38; paclitaxel-eluting stent (PES), n = 41). The high-sensitivity C-reactive protein (hs-CRP) and interleukin 6 (IL-6) levels were determined before and at 24 hours, 72 hours, and 4 weeks after the percutaneous coronary intervention (PCI). An angiography and intravascular ultrasound (IVUS) were performed.

Results: The hs-CRP and IL-6 levels at baseline did not differ between the two groups. The hs-CRP increased significantly from baseline at 24 hours and 72 hours after the PCI in both groups and there was a significant increase in the IL-6 level at 24 hours after the PCI in both groups. However, there was no significant difference between the two groups in any of the hs-CRP or IL-6 measurements. At follow-up, the late lumen loss was significantly higher in the PES group than in the SES group (0.57 (0.56) mm vs 0.28 (0.58) mm, respectively, p = 0.020). The neointimal hyperplasia (NIH) volume in the PES group was significantly higher than that in the SES group (23.1 (22.7) vs 3.8 (7.1) mm³, respectively, p = 0.000). The percentage luminal volume reduction was higher in the PES group than in the SES group (18.9 vs 3.9%, p = 0.002). The absolute values or change in the inflammatory markers did not correlate with the NIH or stent volume reduction.

Conclusions: Our study showed that the benefits obtained from the SES, which reduce neointimal proliferation, are not probably mediated by the attenuation of the systemic inflammatory markers hs-CRP or IL-6.

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