ABSTRACT
Objectives:To investigate the correlation of serum lipoprotein-associated phospholipase A2 (Lp-PLA2) with intra-stent restenosis (ISR) after drug-eluting stent (DES) implantation.Methods:A total of 227 patients with coronary artery disease, who were diagnosed with severe epicardial coronary stenosis by coronary angiography (CAG) and treated by percutaneous coronary intervention (PCI) and DES implantation were enrolled in our study. After follow-up for 1-1.5 years, the CAG was performed and the patients were divided into ISR group and non-ISR (nISR) group according to the consequence of CAG. Biochemical data and multiple serum inflammatory factors such as Lp-PLA2, hypersensitive C-reactive protein (hs-CRP), interleukin 2 (IL-2), interleukin 6 (IL-6) and tumor necrosis factor-α (TNF-α) were analyzed before the CAG. Multivariate logistic regression and multiple linear regression were used to analyze the influencing factors of stent restenosis after DES implantation.Results:The level of serum Lp-PLA2 and the proportion of hypertension in ISR group were significantly higher than those in nISR group, and the level of high density lipoprotein cholesterol (HDL-C) was significantly lower than that in nISR group (all P<0.05), but there was no significant difference in other biochemical indexes and inflammatory factors between the two groups (all P>0.05). The minimum lumen diameter of stent segment in ISR group was significantly lower than that in nISR group ( t=14.975, P<0.01), and the stenosis degree of stent segment diameter was significantly higher than that in nISR group ( P<0.01). Multivariate logistic regression analysis showed that Lp-PLA2 remained an independent predictor for ISR (1.011, 95% CI: 1.005-1.017). Only the serum levels of Lp-PLA2 had linear relationship with the degree of ISR by multivariate linear regression analysis ( β=0.790, P<0.01). Conclusions:Serum Lp-PLA2 level is independently associated with an increased risk of ISR in patients with coronary heart disease.
ABSTRACT
Resumen Las enfermedades cardiovasculares son la principal causa de muerte a nivel mundial y dentro de éstas se encuentra la enfermedad obstructiva de las arterias coronarias. El tratamiento más común para dicha enfermedad es la angioplastia con stent, que busca recuperar la luz de la arteria y revascularizar al paciente. Desde la aprobación del primer stent metálico la cardiología intervencionista ha experimentado un desarrollo continuo, impulsado por la necesidad de tener alternativas de tratamiento más seguras y eficaces. Dichos avances se reflejan en cuatro generaciones de stents liberadores de fármacos. El presente artículo busca describir las principales características de cada una de estas generaciones.
Abstract Cardiovascular disease is the leading cause of death worldwide and within these the coronary artery disease. The most common treatment for this condition is angioplasty with stent, which seeks to recover the lumen of the artery and revascularization the patient. Since the adoption of the first bare metal stent the area of interventional cardiology has experienced continuous development driven by the need for a safe and effective alternative treatment. These advances are reflecting in four generations of drug-eluting stents. This article aims to describe the main features of each of these generations.