Abstract W P231: Relationship Between Perioperative Levels of Circulating Biomarkers and Thromboembolic Events Developing After Carotid Artery Stenting

Abstract

Objective: To evaluate the relationship between the perioperative levels of circulating biomarkers and the development of thromboembolic events after carotid artery stenting (CAS) in patients receiving dual antiplatelet therapy including clopidogrel. Patients and Methods: In the present study, we examined 47 consecutive patients (mean ± SD age, 71.2 ± 5.9 years; 44 men) with carotid artery stenosis who were treated with CAS from February 1, 2011, to July 31, 2013. We prospectively evaluated the levels of circulating biomarkers (high-sensitivity C-reactive protein [hs-CRP], interleukin 6, serum amyloid A, vascular cell adhesion molecule 1 [VCAM-1], intercellular adhesion molecule 1, plasminogen activator inhibitor type 1, and fibrinogen) during the periprocedural period (at 4 days and 1 day preoperatively as well as at 1 day and 3 days postoperatively). The presence of thromboembolic events was determined by diffusion-weighted magnetic resonance imaging (MRI) performed 72 h after CAS. Results: In total, 14 (29.8%) patients indicated new lesions on diffusion-weighted MRI. We noted a significant correlation between the degree of stenosis and the presence of thromboembolic events (p < 0.01). However, the baseline characteristics (age, sex, and risk factors) were not correlated. Increased preprocedural levels of VCAM-1 was significantly associated with new lesions on diffusion-weighted MRI (p < 0.01). None of the other biomarkers were correlated with new lesions. Conclusion: The VCAM-1 level at 1 day prior to CAS are predictive of thromboembolic events developing within 3 days after the procedure. Our data suggest that endothelial dysfunction are associated with thromboembolic events in patients undergoing CAS.