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Updated: Aug 23, 2026
Coronary Progenitor Cells and Soluble Biomarkers in Cardiovascular Prognosis after Coronary Angioplasty
Published on: January 28, 2020
[Effect of percutaneous intervention on adrenomedullin and tumor necrosis factor in the coronary circulation]
Hai-chao Liu1, Ying-feng Liu, Zhi-liang Li
1Department of Cardiology, Zhujiang Hospital, First Military Medical University, Guangzhou 510282, China. lhclht@vip.sina.com
Insights
Percutaneous coronary intervention (PCI) increases coronary levels of adrenomedullin (ADM) and tumor necrosis factor alpha (TNF-alpha) in patients with coronary heart disease (CHD). These elevations are linked to procedural injury and stent deployment.
Area of Science:
- Cardiovascular Medicine
- Biomarkers
- Interventional Cardiology
Context:
- Coronary heart disease (CHD) management often involves percutaneous coronary intervention (PCI).
- Understanding the systemic and local inflammatory responses to PCI is crucial for patient outcomes.
- Adrenomedullin (ADM) and tumor necrosis factor alpha (TNF-alpha) are key inflammatory mediators.
Purpose:
- To investigate the impact of PCI on coronary sinus levels of ADM and TNF-alpha in CHD patients.
- To differentiate the effects of coronary angiography from angioplasty and stenting on these biomarkers.
- To assess the temporal changes in ADM and TNF-alpha post-PCI.
Summary:
- PCI, including percutaneous transluminal coronary angioplasty (PTCA) and stenting, significantly elevated coronary sinus levels of ADM and TNF-alpha in CHD patients.
- Coronary angiography alone did not induce significant changes, suggesting procedural trauma and mechanical stimulation from stents are primary drivers.
- ADM levels returned to baseline post-procedure, while TNF-alpha continued to rise, indicating distinct inflammatory kinetics.
Impact:
- The findings highlight the inflammatory response triggered by PCI, potentially contributing to procedural complications.
- Results suggest ADM and TNF-alpha could serve as indicators of vascular injury and inflammation post-PCI.
- This research provides insights into the pathophysiology of PCI and informs clinical management strategies for CHD.
Objective:
To evaluate the effect of percutaneous intervention (PCI) on coronary circulation levels of adrenomedullin (ADM) and tumor necrosis factor alpha (TNF-alpha) in patients with coronary heart disease (CHD).
Methods:
Thirty-three CHD patients underwent percutaneous transluminal coronary angioplasty (PTCA) and stenting (altogether 48 stents were implanted). Blood samples were collected from the coronary sinus and femoral artery at the time points of immediately before and after angioplasty, immediately after PTCA or stenting, 10 min after procedures, respectively.
Results:
The ADM and TNF-alpha levels in the coronary sinus varied little after coronary angiography, but were elevated markedly following PTCA from the basal levels of 36.3+/-1.3 pg/ml to 28.9+/-1.9 pg/ml (P<0.01) and from 11.10+/-0.46 ng/ml to 8.84+/-0.37 ng/ml (P<0.01), respectively. Further increases of ADM and TNF-alpha levels were detected immediately after stent deployment. ADM recovered to basal levels 10 min after completion of the procedures, while TNF-alpha underwent further increase. Before the procedure, ADM and TNF-alpha levels were higher in the coronary sinus than in the femoral artery (28.9+/-1.9 pg/ml vs 22.6+/-0.8 pg/ml, P<0.01; 8.84+/-0.37 ng/ml vs 7. 56+/-0.23 ng/ml, P<0.01, respectively), and their levels in the femoral artery did not undergo significant changes in response to the operations.
Conclusion:
The coronary circulation levels of ADM and TNF-alpha increase after PTCA and stenting but not after coronary angiography in CHD patients, which might be attributed to injuries by the procedures as well as the mechanical stimulation by the stent.