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Clinical and research medicine: Acute coronary syndrome
e0435 The doublefaced metabolic and inflammatory effects of standard drug therapy in patients after drugeluting stent implantation
  1. Liu Weimin,
  2. Wang Lijun,
  3. Wu Yue,
  4. Liu Xiaojun,
  5. Yuan Zuyi
  1. First Affiliated Hospital of Medical College Xi'an Jiaotong University

Abstract

Objective The inflammatory response and the long-term endothelium healing after drug-eluting stent (DES) placement has recently emerged as a major concern. We investigated the change of metabolic parameters and systematic inflammatory status of circulating mononuclear cells (MNC) in patients after coronary DES implantation.

Methods 27 patients with non-ST segmental elevation acute coronary syndrome that had undergone DES implantations were consecutively recruited and administrated with standard drug therapy for 12 weeks. The systematic inflammation on MNC was measured before DES implantations and after 12 weeks’ medication. NF-κB binding activity in MNC and expression of its subunits p65 and p50, and depressed cytosolic IκB expression of MNC were detected to reveal the systematic inflammation after DES implantations.

Results Metabolic parameters total cholesterol, triglycerides, HDL, LDL improved significantly after 12 weeks’ standard medication, but plasma concentrations of interleukin-6, tumour necrosis factor-α, migration inhibitor factor, and matrix metalloproteinase-9 increased compared with baseline (p=0.012, 0.035, 0.062 and 0.112, respectively). The NF-kB DNA binding activity in MNC increased significantly compared with baseline (p=0.015), concomitantly with decreased IκB-β (p=0.052) and PPAR-γ in MNC (p=0.002). Although there were strong correlations within the change of metabolic parameters and within the change of proinflammatory factors, no significant correlations between them were observed.

Conclusions Standard drug therapy can improve metabolic parameters, but fail to restrain the deteriorated systemic inflammatory responses prolonged at least 3 month. These findings raise concern about the efficiency of the current standard therapy in the era of DES. However, longer term endpoint-based studies are necessary to further explore the relationship between the inflammatory factors and the clinical cardiovascular events.

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