Changes in CCR2 Chemokine Receptor Expression and Plasma MCP-1 Concentration after the Implantation of Bare Metal Stents Versus Sirolimus-eluting Stents in Patients with Stable Angina

Abstract

Although restenosis after successful coronary stenting is associated with changes in adhesion molecules and chemokines, it is unclear whether the differential effects of these molecules between a bare metal stent (BMS) and sirolimus-eluting stent (SES) may help to prevent coronary restenosis. The aim of this clinical study was to compare the expression levels of those molecules after elective placement of either a BMS or SES. The subjects included 32 consecutive patients with stable angina who had undergone successful coronary stenting and who randomly received either a BMS (n=16) or SES (n=16). Quantitative angiographic analysis 6 months after stenting showed that the minimal lumen diameter was significantly greater in the SES as compared to the BMS group, while the percent diameter stenosis and in-stent lumen loss were significantly lower. Plasma monocyte chemotactic protein-1 (MCP-1) increased significantly after 14 days and 6 months and monocyte CCR2 expression increased 24 hr and 48 hr after stenting in the BMS but not the SES group. Changes in plasma MCP-1 (DeltaMCP-1) within 6 months after stenting correlated significantly with in-stent lumen loss. The DeltaMCP-1 (between 6 months and baseline) was significantly related only to the lumen loss (r=0.443, p=0.023), which suggests that the reduction of MCP-1 is the best contributor to decreased lumen loss. These data suggest that reduction in MCP-1 production by SES may be one mechanism to prevent restenosis after coronary stenting.