Effects of different drug eluting stents on inflammatory factors in elderly patients with non-ST-segment elevation acute coronary syndrome

doi:10.3969/j.issn.2095-4344.2014.52.010

Abstract

Abstract:

BACKGROUND: Rapamycin eluting stent and its derivative-the everolimus eluting stent can improve the general inflammatory reaction after stent implantation in patients with acute coronary syndrome, and reduce the incidence of restenosis. Firebird stent as a domestic rapamycin eluting stent is currently the most widely used in China, while XIENCE.V stent as an everolimus eluting stent is the most widely used

OBJECTIVE: To compare the effects of domestic Firebird stent and imported XIENCE.V stent on serum high-sensitivity C-reactive protein and interleukin-6 levels after stent implantation in elderly patients with non-ST segment elevation acute coronary syndrome.

METHODS: Totally 112 elderly patients with non-st segment elevation acute coronary syndrome, including 65 cases of acute non-ST segment elevation myocardial infarction and 47 cases of unstable angina pectoris, were enrolled from September 2012 to July 2014. After 72 hours medical treatment, the patients were subject to percutaneous coronary intervention and divided into two groups: Firebird stent group and XIENCE.V stent group. RESULTS AND CONCLUSION: There was no difference in the levels of serum high-sensitivity C-reactive protein and interleukin-6 between the two groups after stent implantation. The serum high-sensitivity C-reactive protein and interleukin-6 levels at 24 hours after stenting were significantly increased in each group compared with the baseline (P < 0.01), while the levels of high-sensitivity C-reactive protein and interleukin-6 were declined significantly after

1 month of stent implantation (P < 0.05). However, there was no difference in the levels of serum high-sensitivity C-reactive protein and interleukin-6 between the two groups at 24 hours, 1 week, and 1 month after stent implantation. No cardiac accidents occurred in the two groups during and 1 month after percutaneous coronary intervention and stent implantation. Two groups had similar security and histocompatibility. The results confirm that both of Firebird stent and XIENCE.V stent can inhibit inflammatory responses and have similar clinical efficacy in elderly patients with non-ST segment elevation acute coronary syndrome.

中国组织工程研究杂志出版内容重点：生物材料；骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性；组织工程

全文链接：

Key words: tissue engineering, C-reactive protein, stents, interleukin-6

CLC Number:

R318

Lu Miao, Wang Xiang-ming, Wang Sen, Zhou Chuan-wei. Effects of different drug eluting stents on inflammatory factors in elderly patients with non-ST-segment elevation acute coronary syndrome [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(52): 8414-8419.

Figures/Tables 1

References

[1] 姚丽梅.国产雷帕霉素支架置入后血管再狭窄与炎症指标的变化[J].中国组织工程研究与临床康复,2009,13(43): 8446-8449.
[2] 克非,尹栋,昊元,等.成功置入FIREBIRD支架和CYPHER支窦架远期临床疗效比较:单中心注册研究分析结果[J].中国循环杂志, 2012,27(2):99-102.
[3] 聂绍平.依维莫司洗脱支架用于冠心病安全性和有效性的新证据[J].心血管病学进展,2012,33(6):683-685.
[4] Riezebos RK, Verheugt FW, Laarman GJ, et al.The biochemical aspects of a non-ST-segment elevation acute coronary syndrome. Rev Cardiovasc Med. 2012;13(2-3):e70-e76.
[5] Jukema JW, Verschuren JJ, Ahmed TA,et al. Restenosis after PCI. Part 1: pathophysiology and risk factors. Nat Rev Cardiol. 2011;9(1):53-62.
[6] 李晓涛.炎症反应在冠脉支架置入后再狭窄中的研究进展[J].心血管病学进展,2007,28(5):703-705.
[7] 逢淑峰,徐大海,赵利华.冠状动脉内支架置入后再狭窄与炎症反应[J].实用心脑肺血管病杂志,2011,19(20):163-165.
[8] 裴汉军.药物洗脱支架再狭窄治疗的研究进展[J].心血管病学进展, 2013,34(2):174-177.
[9] Sun D, Zheng Y, Yin T, et al. Coronary drug-eluting stents: from design optimization to newer strategies. J Biomed Mater Res A. 2014;102(5):1625-1640.
[10] 赵慧强,郭文怡,贾国良,等.雷帕霉素洗脱支架对冠心病患者介入置入后血炎症因子的影响[J].中国循环杂志,2005,20(2):98-101.
[11] 庞明杰,张宏,赵燕,等.依维莫司洗脱支架在急性冠脉综合征中应用的效果分析[J].医学前沿,2013,4:20-21.
[12] Anderson JL, Adams CD, Antman EM, et al. 2012 ACCF/AHA focused update incorporated into the ACCF/AHA 2007 guidelines for the management of patients with unstable angina/non-ST-elevation myocardial infarction: a report of the american college of cardiology foundation/american heart association task force on practice guidelines. Circulation. 2012,126(7):875-910.
[13] 刘治军.2012年ACCF/AHA对不稳定心绞痛/非ST段抬高的心肌梗死患者管理的指南更新简介[J].药品评价,2013,10(22):19-24.
[14] 许春平,赵献明,曾波,等.阿托伐他汀预处理对非杂栽抬高急性冠脉综合征患者行冠脉支架置入后炎性因子和预后的影响[J].河北医药,2013,19(8):1202-1204.
[15] 杨帆,赵雅琳,葛华.冠心病患者行冠状动脉支架置入后外周血小板P-选择素及血清hsCRP的动态变化[J].中国试验诊断学,2010, 14(7):1117-1118.
[16] 吴铮,李文铮,李世英.介入治疗对老年冠心病患者脑钠肽和超敏C反应蛋白水平的影响[J].中国基层医药,2014,21(8):1132-1133.
[17] 章敏,蒋红丽.老年冠心病支架置入后血清IL-6与TNF-α水平改变及黄芪注射液的干预作用[J].中国实用诊断与治疗杂志, 2008, 22(11):832-834.
[18] 莫文,焦桂萍,袁志柳,等.血清hsCRP, TNF-α, IL-6, 血脂水平对慢性脑供血不足的诊断价值[J].中国试验方剂学杂志, 2011, 17(13): 235-236.
[19] Ramasamy I. Biochemical markers in acute coronary syndrome. Clin Chim Acta. 2011;412(15-16):1279-1296.
[20] Sami S, Willerson JT. Contemporary treatment of unstable angina and non-ST-segment-elevation myocardial infarction (part 2). Tex Heart Inst J. 2010;37(3):262-275.
[21] Koenig W. High-sensitivity C-reactive protein and atherosclerotic disease: from improved risk prediction to risk-guided therapy. Int J Cardiol. 2013;168(6):5126-5134.
[22] 毛庆录,宋书凯,李敬田.急性冠脉综合征支架置入后早期血清hsCRP、MMP-9、IL-18的变化及意义[J].山东医药,2009,49(9): 6-8.
[23] Hartman J, Frishman WH. Inflammation and atherosclerosis: a review of the role of interleukin-6 in the development of atherosclerosis and the potential for targeted drug therapy. Cardiol Rev. 2014;22(3):147-151.
[24] 王远东,刘敏.冠状动脉支架置入后C-反应蛋白、白介素-6的变化及意义[J].健康必读杂志,2012,8(8):281.
[25] 佟子川,张建军,魏好,等.不同类型药物洗脱支架介入治疗对血清C反应蛋白和白细胞介素6水平的影响[J].临床心血管病杂志, 2010,26(10):766-769.
[26] 王子超,刘静,高传玉,等.冠状动脉雷帕霉素洗脱支架置入对患者血清CRP及IL-2水平的影响及临床价值[J].心脑血管病防治, 2008,8(1):31-32.
[27] 卢强.冠状动脉支架置入置入后早期炎性标记物的观察[J].河北医药,2009,31(20):2738-2739.
[28] 刘晨,王智慧.IL-6、IL-8水平与冠状动脉支架置入置入后再狭窄相关性分析[J].中国试验诊断学,2011,15(1):99-101.
[29] Giordano A, Romano A. Inhibition of human in-stent restenosis: a molecular view. Curr Opin Pharmacol. 2011; 11(4):372-377.
[30] 杜健鹏.冠状动脉药物涂层支架后再狭窄与炎症反应的相关性[J].心血管病学进展,2009,30(5):791-794.
[31] Chaabane C, Otsuka F, Virmani R, et al. Biological responses in stented arteries. Cardiovasc Res. 2013;99(2):353-363.
[32] Okura H, Takagi T, Yoshida K. Therapies targeting inflammation after stent implantation. Curr Vasc Pharmacol. 2013;11(4):399-406.
[33] Palmerini T, Biondi-Zoccai G, Della Riva D, et al. Stent thrombosis with drug-eluting stents: is the paradigm shifting? J Am Coll Cardiol. 2013;62(21):1915-1921.
[34] 张书富,郑鹏翔,陈德,等.国产Firebird支架在急性冠状动脉综合征急诊介入治疗中的作用[J].实用医学杂志,2009,25(4): 593-595.
[35] 郑雨田.新一代冠状动脉药物洗脱支架临床应用进展[J].国际生物医学工程杂志,2012,35(5):312-316.
[36] Onuma Y, Serruys PW, Muramatsu T, et al. Incidence and imaging outcomes of acute scaffold disruption and late structural discontinuity after implantation of the absorb everolimus-eluting fully bioresorbable vascular scaffold: optical coherence tomography assessment in the absorb cohort b trial (a clinical evaluation of the bioabsorbable everolimus eluting coronary stent system in the treatment of patients with de novo native coronary artery lesions). JACC Cardiovasc Interv. 2014;7(12):1400-1411.
[37] Wöhrle J, Naber C, Schmitz T, Schwencke C, et al. Beyond the early stages: insights from the ASSURE registry on bioresorbable vascular scaffolds. EuroIntervention. 2014 doi: 10.4244/EIJY14M12_10.
[38] Takashima A, Shimabukuro M, Tabata M, et al. Histopathological heterogeneity of in-stent restenosis in four coronary endarterectomy specimens. Cardiovasc Pathol. 2014. doi: 10.1016/j.carpath.2014.11.002.
[39] Luca T, Giuseppe BZ, Fabrizio T, et al. Italian Diffuse/Multivessel Disease ABSORB Prospective Registry under the auspices of Società Italiana di Cardiologia Invasive-GISE (IT-DISAPPEARS): study design and rationale. J Cardiovasc Med (Hagerstown). 2014 [Epub ahead of print].
[40] Wiebe J, Liebetrau C, Dörr O, et al. Feasibility of everolimus-eluting bioresorbable vascular scaffolds in patients with chronic total occlusion. Int J Cardiol. 2015;179: 90-94.
[41] Cho S, Shin D, Kim J, et al. Rationale and design: Impact of intravascular ultrasound guidance on long-term clinical outcomes of everolimus-eluting stents in long coronary lesions. Contemp Clin Trials. 2014;40C:90-94.
[42] Kochman J, Tomaniak M, Pietrasik A, et al. Bioresorbable everolimus-eluting vascular scaffold in patients with ST-segment elevation myocardial infarction: Optical coherence tomography evaluation and clinical outcomes. Cardiol J. 2014. doi: 10.5603/CJ.a2014.0090.
[43] Won H, Kang TS, Hong BK, et al. Neointimal response to second-generation drug-eluting stents in diabetic patients with de-novo coronary lesions: intravascular ultrasound study. Coron Artery Dis. 2014 [Epub ahead of print].
[44] Karbassi A, Kassaian SE, Poorhosseini H, et al. Selective versus exclusive use of drug-eluting stents in treating multivessel coronary artery disease: a real-world cohort study. Tex Heart Inst J. 2014;41(5):477-483.
[45] Adriaenssens T, Ughi GJ, Dubois C, et al. STACCATO (Assessment of Stent sTrut Apposition and Coverage in Coronary ArTeries with Optical coherence tomography in patients with STEMI, NSTEMI and stable/unstable angina undergoing everolimus vs. biolimus A9-eluting stent implantation): a randomised controlled trial. EuroIntervention. 2014. doi: 10.4244/EIJY14M11_11.
[46] Doostzadeh J, Clark LN, Bezenek S, et al. Recent progress in percutaneous coronary intervention: evolution of the drug-eluting stents, focus on the XIENCE V drug-eluting stent. Coron Artery Dis. 2010;21(1):46-56.
[47] 刘小熊,夏豪,万埝,等.依维莫司药物洗脱支架与西罗莫司药物洗脱支架治疗冠心病疗效的Meta分析[J].中国循证心血管医学杂志,2013,5(2):111-115.