Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries

Young Joon Hong, Myung Ho Jeong, Sang Yup Lim, Sang Rok Lee, Kye Hun Kim, Il Suk Sohn, Hyung Wook Park, Ju Han Kim, Weon Kim, Youngkeun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang

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Abstract

Background: The mechanism of restenosis after stent implantation principally is neointimal hyperplasia. There is evidence that monocytes play a important role in in-stent restenosis (ISR) after stent implantation. Hypothesis: This study assessed the relationship between preinterventional peak monocyte count and neointimal growth after successful stent implantation. Methods: We performed coronary stent implantation in 85 patients (85 de novo lesions). Peripheral blood sample was obtained in all patients every 12 h before coronary angiography for measurement of peripheral monocytes. All patients received angiographic and intravascular ultrasound (IVUS) follow-up at 6 months after stenting. Results: The preinterventional circulating monocyte count was significantly higher in the ISR group than that in the group without ISR (654 ± 62/vs. 461 ± 222/mm3, p < 0.001) and was significantly higher in the reintervention group than that in the no-reintervention group (660 ± 72/vs. 470 ± 216/mm3, p < 0.001). The incidence of ISR and repeat intervention associated with preinterventional monocyte count was highest among the patients in the highest tertile, who were at a 2.64-fold increased risk of ISR and 3.22-fold increased risk of repeat intervention compared with the patients in the lowest tertile. A significant positive correlation was found between preinterventional peak monocyte count and preinterventional plaque and media cross-sectional area and follow-up neointima area (r = 0.311, p = 0.007, r = 0.465, p < 0.001, respectively). The neointima area associated with preinterventional monocyte count was largest among the patients in the highest tertile, that is, 2-fold larger than that of the patients in the lowest tertile (p < 0.001) and 1.44-fold larger than that of the patients in the middle tertile (p = 0.001). Conclusion: Our results suggest that circulating preinterventional monocytes play a principal role in the process of in-stent neointimal growth after successful stent implantation.

Original languageEnglish
Pages (from-to)512-518
Number of pages7
JournalClinical Cardiology
Volume28
Issue number11
DOIs
Publication statusPublished - 2005 Nov

Keywords

  • Coronary artery disease
  • Inflammation
  • Restenosis
  • Stents

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Hong, Y. J., Jeong, M. H., Lim, S. Y., Lee, S. R., Kim, K. H., Sohn, I. S., Park, H. W., Kim, J. H., Kim, W., Ahn, Y., Cho, J. G., Park, J. C., & Kang, J. C. (2005). Preinterventional peak monocyte count and in-stent intimal hyperplasia after coronary stent implantation in human coronary arteries. Clinical Cardiology, 28(11), 512-518. https://doi.org/10.1002/clc.4960281105