Coronary aspirate TNFα reflects saphenous vein bypass graft restenosis risk in diabetic patients

Cardiovascular Diabetology

Original Investigation

Petra Kleinbongard¹  Gerd Heusch¹  Theodor Baars¹  Thomas Konorza²  Raimund Erbel²  Philipp Kahlert²  Stefan Möhlenkamp³ 

[1] Institut für Pathophysiologie, Universitätsklinikum Essen, Hufelandstr. 55, 45122, Essen, Germany;Klinik für Kardiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Germany;Krankenhaus Bethanien Moers, Moers, Germany;

关键词: Coronary disease;    Diabetes mellitus;    Ischemia;    TNFα;    Vasoconstriction;   

DOI  :  10.1186/1475-2840-12-12

 received in 2012-12-14, accepted in 2013-01-08,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundPatients with diabetes mellitus (DM) have an increased risk for periprocedural complications and adverse cardiac events after percutaneous coronary intervention. We addressed the potential for coronary microvascular obstruction and restenosis in patients with and without DM undergoing stenting for saphenous vein bypass graft (SVG) stenosis under protection with a distal occlusion/aspiration device.MethodsSVG plaque volume and composition were analyzed using intravascular ultrasound before stent implantation. Percent diameter stenosis was determined from quantitative coronary angiography before, immediately after and 6 months after stent implantation. Coronary aspirate was retrieved during stent implantation and divided into particulate debris and plasma. Total calcium, several vasoconstrictors, and tumor necrosis factor (TNF)α in particulate debris and coronary aspirate plasma were determined.ResultsPatients with and without DM had similar plaque volume, but larger necrotic core and greater particulate debris release in patients with than without DM (20.3±2.7 vs. 12.7±2.6% and 143.9±19.3 vs. 75.1±10.4 mg, P<0.05). The TNFα concentration in particulate debris and coronary aspirate plasma was higher in patients with than without DM (15.9±6.6 vs. 5.1±2.4 pmol/mg and 2.2±0.7 vs. 1.1±0.2 pmol/L, P<0.05), whereas total calcium and vasoconstrictors were not different. Patients with DM had a greater percent diameter stenosis 6 months after stent implantation than those without DM (22.17±5.22 vs. 6.34±1.11%, P<0.05). The increase in TNFα immediately after stent implantation correlated with restenosis 6 months later (r=0.69, P<0.05).ConclusionIn diabetics, particulate debris and coronary aspirate plasma contained more TNFα, which might reflect the activity of the underlying atherosclerotic process.Trial registrationURL: http://www.clinicaltrials.gov/ct2/results?term=NCT01430884; unique identifier: NCT01430884

【 授权许可】

Unknown   
© Baars et al.; licensee BioMed Central Ltd. 2013. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.