Changes in CCR2 Chemokine Receptor Expression and Plasma MCP-1 Concentration after the Implantation of Bare Metal Stents Versus Sirolimus-eluting Stents in Patients with Stable Angina

• Published in: Internal Medicine Vol. 47; no. 1; pp. 7 - 13
• Main Authors: Sako, Hideto, Miura, Shin-ichiro, Iwata, Atsushi, Nishikawa, Hiroaki, Kawamura, Akira, Matsuo, Kunihiro, Shirai, Kazuyuki, Saku, Keijiro
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Society of Internal Medicine 2008
• Subjects: adhesion molecules; Aged; Angina; Angina Pectoris - blood; Angina Pectoris - diagnostic imaging; Angina Pectoris - therapy; Autoantigens - biosynthesis; Autoantigens - blood; bare metal stent; CC chemokine receptors; CCR2 protein; Chemokine receptors; Coronary Angiography; Coronary Restenosis - blood; Coronary Restenosis - diagnostic imaging; Coronary Restenosis - prevention & control; Data processing; Drug-Eluting Stents; Female; Gene Expression; Humans; Immunosuppressive Agents - pharmacology; Implants; Male; Metals; Middle Aged; Monocyte chemoattractant protein 1; Monocytes; Receptors, CCR2 - biosynthesis; restenosis; Sirolimus - pharmacology; sirolimus-eluting stent; Stenosis; Stents
• ISSN: 0918-2918; 1349-7235; 1349-7235
• DOI: 10.2169/internalmedicine.47.0315

Background Although restenosis after successful coronary stenting is associated with changes in adhesion molecules and chemokines, it is unclear whether the differential effects of these molecules between a bare metal stent (BMS) and sirolimus-eluting stent (SES) may help to prevent coronary restenosis. The aim of this clinical study was to compare the expression levels of those molecules after elective placement of either a BMS or SES. Methods and Results The subjects included 32 consecutive patients with stable angina who had undergone successful coronary stenting and who randomly received either a BMS (n=16) or SES (n=16). Quantitative angiographic analysis 6 months after stenting showed that the minimal lumen diameter was significantly greater in the SES as compared to the BMS group, while the percent diameter stenosis and in-stent lumen loss were significantly lower. Plasma monocyte chemotactic protein-1 (MCP-1) increased significantly after 14 days and 6 months and monocyte CCR2 expression increased 24 hr and 48 hr after stenting in the BMS but not the SES group. Changes in plasma MCP-1 (ΔMCP-1) within 6 months after stenting correlated significantly with in-stent lumen loss. The ΔMCP-1 (between 6 months and baseline) was significantly related only to the lumen loss (r=0.443, p=0.023), which suggests that the reduction of MCP-1 is the best contributor to decreased lumen loss. Conclusions These data suggest that reduction in MCP-1 production by SES may be one mechanism to prevent restenosis after coronary stenting.