Inflammatory Response after Coronary Stent Implantation Depending on Plaque Morphology Assessed by Intravascular Ultrasound

Background:Percutaneous coronary intervention (PCI) is associated with an increase in inflammatory activity provoked by plaque rupture, arterial wall damage and endothelial injury.
Purpose: to study the inflammatory response after coronary stenting of patients with coronary artery disease, according to atherosclerotic plaque morphology.
Materials and Methods: we studied 34 patients with coronary artery disease, who undergone PCI for single lesions. Virtual histology-intravascular ultrasound was performed before stenting in all patients for determination of phenotype of atherosclerotic plaques. Atherosclerotic plaques with a thick fibrous cap (fibroatheromas, FA) were identified in 18 patients (group 1), thin-cap fibroatheromas (TCFA) in 10 patients (group 2), patients with fibrotic and fibrocalcific plaques were included in group 3 (n=6). Pre- and postprocedural (24h after PCI) blood levels of high sensitivity C-reactive protein (hsCRP), interleukin (IL)-6, IL-8, IL-2 receptor (IL-2R) were measured.
Results: At baseline all inflammatory markers were comparable in three group. In group 1 post-PCI levels of CRP, IL-6, IL-8, IL-2R was increased by 30% (p=0.03), 100% (p=0.05), 120% (p=0.02), 20% (p=0.03), respectively. In group 2 post-PCI levels of CRP, IL-6, IL-8, IL-2R was increased by 85% (p=0.04), 100% (p=0.07), 45% (p > 0.05), 14% (p= 0.07), respectively. In patients of the third group post-PCI CRP level increased by 123% (p=0.046), IL-6 by 250% (p=0.04), whereas IL-8 and IL-2R levels did not change significantly.
Conclusions: The inflammatory response after PCI was observed in all groups, but was more pronounced in patients with fibroatheromas.