Impact of Coronary Novolimus Bioresorbable Scaffold & Novolimus Eluting Stent Implantation on the Acute Inflammatory Response in Diabetic Patients with Coronary Artery Disease

Abstract

Background: The most effective treatment for coronary arteries revascularization in patients suffering from coronary artery disease (CAD) is percutaneous coronary intervention (PCI). However, when a coronary stent implantation is applied to the affected coronary artery, a mechanical injury to the arterial wall may occur causing a local inflammatory response. As a result, immediately after a PCI, a rapid increase in circulatory inflammatory markers may occur. Objective: This study was undertaken to investigate the effect of Novolimus bioresorbable coronary scaffold and Novolimus eluting stent on the acute inflammatory response after implantation in patients with coronary artery disease. Patients and Methods: Between January and July 2015, 44 type II diabetic patients (29 male; 15 female ) with ischemic heart disease (unstable angina) were randomly assigned into two groups: Group1: Novolimus eluting Bioresorbable coronary scaffold implantation group (20 patients) and Group 2 :Novolimus eluting coronary stent implantation group (24 patients) .They were admitted to AL-Najaf center for cardiac surgery and trans catheter therapy and submitted to elective coronary stent implantation. Blood was drawn from peripheral vein directly before implantation, 12 hrs and 24 hrs after implantation and used to measure IL-8, hs-CRP, MMP-9, cTn-I and VCAM-1 levels by sandwich ELISA method. Results: Inflammatory markers in patients subjected to elective Novolimus eluting bioresorbable coronary scaffold were found to be significantly higher than those subjected to Novolimus eluting stent. Specifically (IL-8) levels were found to be elevated at (12, 24) hrs. Levels of hs-CRP, MMP-9, VCAM-1 were found to be elevated at 24 hrs (p 0.05) at (12, 24) hrs. Conclusions patients treated with BRS showed significantly higher increase in inflammatory mediators as compared to patients treated with Novolimus eluting stent.