Sensitive C-reactive protein, serum amyloid A, and neopterin with angiographic in stent restenosis

Abstract

Objective: Vascular inflammation induced by percutaneous coronary intervention (PCI) has an important role in the pathogenesis of in-stent restenosis (ISR). Previous studies have addressed that serum amyloid A (SAA), high sensitive C-reactive protein (hs-CRP), neopterin, and matrix metalloproteinase-9 (MMP-9) play an important role in inflammatory process of development of ISR. Aim: We aimed to investigate the relationship of preprocedural levels of these inflammatory markers and the development of ISR. Methods and Materials: This was a prospective-case controlled study. 76 of 123 screened consecutive patients with stable angina who underwent coronary angiography, were scheduled for bare metal stent (BMS) placement. Control angiography was performed 6-12 months after the index intervention. Results: ISR was documented in the of 23 patients (30%), it was not documented in the remaining 53 patients (70%). The basal serum neopterin level was 2.32 ± 1.27 ng/ml and 1.67 ± 0.89 ng/ml, hs-CRP level was 9.16 ± 8.73 mg/L and 5.85±5.59 mg/L, the serum basal SAA level was 18.28 ±39.84 ng/ml and 12.77±23.67 ng/ml, the serum basal MMP-9 level was 75.06 ±35.05 ng/ml and 66.78±38.32 ng/ml, in patients with and without restenosis, respectively. Neopterine and hs-CRP levels exhibited a significant association with the ISR (p:0.01, p:0.04, respectively), SAA and MMP-9 levels did not (p:0.46, p:0.36, respectively). Conclusions: In present study, serum baseline neopterin and hs-CRP concentrations were predictive for the development of ISR. We also observed a significant correlation between the neopterin and hs- CRP in restenosis group.