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Granulocyte activation in restenosis after percutaneous transluminal coronary angioplasty
M Tsutsui1, H Shimokawa, S Tanaka
1Department of Cardiology, Iizuka Hospital, Japan.
Insights
Granulocyte activation may play a role in restenosis after percutaneous transluminal coronary angioplasty (PTCA). Elevated granulocyte elastase levels at three months post-PTCA were linked to restenosis development.
Area of Science:
- Cardiovascular Medicine
- Inflammation Research
- Interventional Cardiology
Background:
- Restenosis remains a significant complication following percutaneous transluminal coronary angioplasty (PTCA).
- The precise mechanisms driving restenosis are not fully elucidated, prompting investigation into inflammatory processes.
Purpose of the Study:
- To investigate the potential involvement of granulocyte activation in the development of restenosis after successful PTCA.
- To assess the correlation between plasma levels of granulocyte elastase and restenosis incidence.
Main Methods:
- A prospective study followed 43 patients undergoing successful PTCA.
- Plasma granulocyte elastase levels were measured at baseline, post-procedure, and at 1 and 3 months.
- Restenosis was defined as >50% loss of initial diameter gain at 3-month angiography.
Main Results:
- No significant differences in granulocyte elastase levels were observed between restenosis and non-restenosis groups at baseline, 1 day, or 1 month post-PTCA.
- A significantly higher plasma granulocyte elastase level was found in the restenosis group compared to the non-restenosis group at 3 months post-PTCA (171 ± 13 vs. 147 ± 6 mg/l, P < 0.05).
- Granulocyte elastase levels at 3 months correlated significantly with the degree of luminal stenosis at the angioplasty site.
Conclusions:
- These findings suggest that granulocyte activation, indicated by elevated granulocyte elastase, may contribute to the pathogenesis of restenosis after PTCA.
- Targeting granulocyte activation could be a potential therapeutic strategy to prevent restenosis.
Abstract:
To examine whether or not granulocyte activation is involved in restenosis after percutaneous transluminal coronary angioplasty (PTCA), we prospectively followed the time course of the plasma level of granulocyte elastase, which is an index of granulocyte activation, before and after successful angioplasty in 43 consecutive patients. Restenosis was defined as a more than 50% loss of the initial gain in the coronary diameter achieved by PTCA with more than a 50% resultant stenosis in the follow-up coronary arteriography performed 3 months after PTCA. There was no difference in the level of granulocyte elastase between the 2 groups with (n = 15) and without (n = 28) restenosis before, the day after and 1 month after PTCA. However, 3 months after PTCA, the level of granulocyte elastase was significantly higher in the group with restenosis than in that without restenosis (171 +/- 13 vs 147 +/- 6 mg/l, P < 0.05). The level of granulocyte elastase at 3 months after PTCA also correlated significantly with the percent luminal stenosis at the angioplasty site (P < 0.05). These results suggest that granulocyte activation may be involved in restenosis after PTCA.