Inflammatory response after dexamethasone eluting coronary stent implantation

• Published in: Revue roumaine de médecine interne (1990) Vol. 42; no. 1; p. 119
• Main Authors: Mut-Vitcu, B, Drăgulescu, S I, Drăgulescu, Andreea, El Kahlout, A, Coroban, Adriana, Maximov, Daniela, Slovenski, M
• Format: Journal Article
• Language: English
• Published: Germany 2004
• Subjects: Anti-Inflammatory Agents - administration & dosage; C-Reactive Protein - metabolism; Coronary Disease - therapy; Dexamethasone - administration & dosage; Drug Delivery Systems; Female; Humans; Inflammation - drug therapy; Male; Middle Aged; Prospective Studies; Risk Factors; Stents; Treatment Outcome
• ISSN: 1220-4749

C-reactive protein (CRP) elevation after coronary stent implantation is a predictor for recurrence. We prospectively evaluated the inflammatory response after dexamethasone eluting stent implantation in a native coronary artery by serial measurement of plasma level C-reactive protein. We investigated patients undergoing primary successful implantation of a single dexamethasone stent (Dexamet, Abbott Vascular Devices, Redwood City, CA, USA) in a native coronary artery. We analyzed plasma concentrations of CRP by immunoturbidimetric assay before stent implantation and 12, 24, 48 and 72 hours after the procedure. Patients on anti-inflammatory drugs or with evidences of inflammatory conditions were excluded. Seventeen patients (mean age 62+/-9 years, 12 males) were enrolled. The presentation was unstable angina in 13 patients and stable angina in 4 patients. Eighteen stents were implanted as follows: 16 type B lesions (88%), 1 type C lesions (6%) and 1 type A lesion (6%), located in LM in 2 patients (11%), LAD in 8 (44%), LCX/OM in 7 (39%), and RCA in 1 patient (6%). The mean CRP increased from 5.6+/-2.2 mg/l at baseline to a maximum of 6.7+/-2.1 mg/l and than decreased to 5.0+/-1.2 mg/l at 72 hours. At 72 hours plasma concentration of CRP was lower than baseline in 11 patients (65%) and higher in 6 (35%). Inflammatory response to dexamethasone stent implantation in a native coronary artery is low and peaks at 24 hours. At 72 hours after stent implantation, mean CRP decreased comparing with baseline, CRP becoming lower in 65% patients. Using the stent itself as a platform for drug delivery may be an opportunity to modulate the inflammatory response to coronary stent implantation.