Motexafin lutetium phototherapy decreases vascular inflammation in rabbit atheroma: Implications for vulnerable plaque therapy

Abstract

ed retrosoectivelv for demoaraohics. oeri-orocedural medications and details ~ _. that might impact on outcome of CPK release. CPK enzymes were routinely ordered at 6, 12. and 18 hours after PCI. IC-CCB or NTG use was soecificallv noted and reflected _ operators standard choice. Post-procedural CPK levels were analyzed using both a repeated measures (ANOVA) and a random coefficient model using a quadratic function. Results: CCB (n=401) and the NTG (n=415) had similar background characteristics and net elevations of CPK. IC-CCB group had an earlier rise in CPK (p=.OOO2 by 8 hrs) and an earlier peak (16.3 hrs vs 26.1 hrs) compared with the IC-NTG group. Conclusions: Routine IC-CCB use is associated with an earlier rise of CPK enzymes after PCI. This supports the role of CCB as vasodilators of the microcirculation and suggests further avenues for research In enhancing blood flow at the tissue level of the myocardium during PCI. 1053-l 99 Effect of Simvastatin on the Inflammatory Response to Coronary Angioplasty Christopher J. Hammett, Ralph A. Stewart, John K. French, Cheuk-Kit Wang, Mark W. Webster, John A. Ormiston, Wanzhen Gao. Harvey D. White, Green Lane Hospital, Auckland, New Zealand Background: Previous studies have reported treatment with the HMG-CoA reductase inhibitor simvastatin reduces serum C-reactive protein (CRP) levels, suggesting an antiinflammatory effect that appears to be fully established within 4 weeks of commencing therapy. Coronary angloplasty is associated with an acute increase rn serum inflammatory markers which may predict early complications. The effect of simvastatin on this inflammatory marker rise is unknown. The aim of this study was to determine whether pre-treatment with slmvastatin reduces the inflammatory response to coronary angioplasty. Methods: We studied 92 patients (mean age 60*10 years) randomised to simvastatin 40mgld (n=52) or placebo (n=40) a median of 1.9 months (IQR 0.9 to 3.6 months) before elective coronary angioplasty. All patients were taking aspirin 150mgIday unless there was a specific contraindication (aspirin use 92% for simvastatin group, 95% for placebo group, p=ns). CRP was measured by high sensitivity immunoassay on serum samples taken immediately prior to and 48 hours after angioplasty. Results: The CRP (median[lQR]) immediately prior to angioplasty was 1.3mgIl (0.712.43) for the placebo group, versus 1.46mgA (0.67-2.14) for the simvastatin group, p=O.79. CRP increased post-PC1 for both groups (p<O.OOi for both simvastatin and placebo). Simvastatin did not alter this inflammatory response; the increase in CRP (preangioplasty to 48 hours post-angioplasty) for patients randomised to simvastatin was 4.68mgIl (IQR 2.9 to 10.3) compared to 5.1fJmg/l (IQR 2.2-9.3) for placebo, (p=O.96). Exclusion of patients on simvastatin for less than 4 weeks prior to angioplasty did not alter this result. Conclusion: There is an increase in CRP measured 48 hours after angioplasty, confirming an inflammatory response. Simvastatin did not significantly influence this inflammatory response. 1053-200 Neither Periprocedural Pregnancy-Associated Plasma Protein A nor C-Reactive Protein Levels Predict Restenosis Christopher J. Hammett, John K. French. Michael Christiansen, Claus Oxvig. Michael T. Overgaard. Bruce J. Webber, Ralph A. Stewart, Cheuk-Kit Wang, Mark W. Webster, John A. Ormiston, Wanzhen Gao, Harvey D. White, Green Lane Hospital, Auckland, New Zealand, Statens Serum Institut, Copenhagen, Denmark Background: Matrix metalloproteinases including Pregnancy-Associated Plasma Protein A (PAPP-A) are abundantly expressed at sites of atherosclerotic plaque rupture, are predictive of acute coronary syndromes when circulating levels are elevated, and may play an important role in the development of restenosis following percutaneous coronary intervention (PCI). C-reactive protein (CRP) levels increase following PCI. peaking at 48 to 72 hours, but the effect of this inflammatory response on restenosis IS unclear. The aim of this study was to determine whether peri-procedural levels of PAPP-A and/or CRP predict restenosis. Methods: We studied 136 patients with stable angina who underwent elective PCI with stored peri-procedural blood samples and corresponding pre-. post-, and six month coronary angiograms; age (meanD CRP prior to PCI 1.2mgA (0.7-2.2), post-PC1 6.6mg/l (4.0.13.2), pcO.0001, PAPP-A prior to PCI 4.lmlUll (3.3&l), post-PC1 b.BmlU/I (4.3-7.2), p<O.OOOl. The median stenosis at six months was 46% (IQR 34.63%) and the binary restenosis rate was 42%. There were