Effects of Drug-eluting Stents on Plasma C-reactive Protein Levels after Coronary Stenting: Comparison with Bare Metal Stents Stents

Abstract

After coronary stenting, inflammatory mechanisms play a crucial role in the pathogenesis of neointimal proliferation and in-stent restenosis. Drug eluting stents(DES) have been shown to reduce in-stent restenosis in various studies. We investigated plasma C-reactive protein (CRP) levels after DES implantation and compared with those after bare metal stent(BMS) implantation. In a prospective single center study, we performed percutaneous coronary intervention with a single stent in 67 patients(n=21 in BMS group, n=46 in DES group) with clinically stable angina. Plasma CRP levels were determined before intervention and 48 hrs, 72 hrs and 2 weeks after coronary stenting. There were 54 men(80.6%) and the age of patients ranged from 37 to 75 years(mean, 59±9 years). There was no difference in clinical and angiographic baseline characteristics except that more diabetic patients were included in DES group(34.8% vs 9.5%, p=0.04) and that the stent diameter was larger in BMS group(3.4±0.5 mm vs 3.0±0.4 mm, p<0.01). The plasma CRP levels at 48(13.4±14.7 vs 5.9±4.9 mg/L, p<0.01) and 72 hrs(16.7±19.8 vs 5.4±3.9 mg/L, p<0.01) after stent implantation were significantly higher in BMS than DES group. DES showed significantly lower plasma CRP levels after coronary stent implantation compared to BMS. This may reflect potent effects of DES on acute inflammatory reactions induced by coronary intervention.