Role of eosinophil granulocytes in the occurrence of restenosis in patients after coronary stenting with drug-eluting stents


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Abstract

AIM. To study the role of eosinophil granulocytes in the development of restenosis after drug-eluting stent (DES) implantation. MATERIALS AND METHODS. The blood levels of eosinophils, eosinophil cationic protein (ECP), immunoglobulin E (IgE), and C-reactive protein (CRP) were compared in 170 patients with coronary heart disease (CHD) and stable angina who had undergone recoronarography within the first year after endovascular myocardial revascularization using DES. The blood level of eosinophils was determined by the results obtained employing the FACS Calibur flow cytofluorometer (Becton Dickinson, USA). That of ECP, IgE, and CRP was estimated by enzyme immunoassay by means of an Immulite-100 analyzer (Siemens, Germany). The data were presented as median (25th percentile and 75th percentile). RESULTS. The blood eosinophil level was 272 (234; 292) cells/µl in patients with restenosis while that was 134 (85; 156) cells/µl in those without restenosis (p=0.002). The plasma ECP level proved to be greater in the patients who had developed restenosis after DES implantation than in those who had not [17.7 (11.2; 24) and 9 (6.4; 12.9) ng/ml, respectively (p=0.017). At 6 months after DES implantation, the level of ECP was significantly higher (8.6 (7.3; 9.7) ng/ml) than the baseline level (p=0.04). Later on, there was an even greater increase in ECP levels. No significant changes were noted in blood ECP levels after bare stent implantation. CONCLUSION. The findings suggest that there is a relationship between the occurrence of restenosis and the enhanced activity of eosinophil granulocytes in CHD patents after DES implantation.

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Роль эозинофильных гранулоцитов в возникновении рестеноза у пациентов после коронарного стентирования с помощью стентов, покрытых лекарственным веществом. - Резюме. Цель исследования. Изучение роли эозинофильных гранулоцитов в развитии рестеноза после имплантации стентов, покрытых лекарственным веществом (СЛП). Материалы и методы. Проведено сопоставление уровня эозинофилов, катионного белка эозинофилов (КБЭ), иммуноглобулина Е (IgE) и С-реактивного белка (СРБ) в крови 170 больных ишемической болезнью сердца (ИБС) со стабильной стенокардией, которым в течение первого года после эндоваскулярной реваскуляризации миокарда с помощью СЛП проведена повторная коронарография. Количество эозинофилов в крови определяли по результатам, полученным на проточном цитофлуориметре FACS Calibur ("Becton Dickinson", США). Уровень КБЭ, IgE и СРБ в крови определяли иммуноферментным методом на анализаторе Immulite-1000 ("Siemens", Германия). Данные представлены в виде медианы (25-й процентиль; 75-й процентиль). Результаты. Уровень эозинофилов в крови пациентов с рестенозом составил 272 (234; 292) клетки в 1 мкл, в то время как в крови больных без рестеноза - 134 (85; 156) клетки в 1 мкл (p=0,002). Уровень КБЭ в плазме крови пациентов, у которых возник рестеноз после имплантации СЛП, оказался выше (p=0,017), чем у больных, у которых рестеноз не обнаружен, - 17,7 (11,2; 24) и 9 (6,4; 12,9) нг/мл соответственно. Уровень КБЭ через 6 мес после имплантации СЛП статистически значимо выше (р=0,04) исходного - 8,6 (7,3; 9,7) нг/мл. В последующем отмечено еще большее увеличение уровня КБЭ. Статистически значимой динамики уровня КБЭ в крови после имплантации стентов без покрытия лекарственным веществом не обнаружено. Заключение. Полученные данные позволяют предположить связь между возникновением рестеноза и повышенной активностью эозинофильных гранулоцитов у пациентов с ИБС после имплантации СЛП.
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