[Different effects of inflammation and lipid levels on coronary lesions after PCI].

OBJECTIVE: To assess the different effects of inflammation and lipid levels before and after PCI on in-stent restenosis and lesion progression. METHODS: Patients were studied who successfully underwent PCI with stent implantation and were received coronary angiography again after three months to one year. In-stent restenosis was observed in 94 patients and lesion progression in 65 patients. No restenosis and lesion progression occurred in 307 cases. Total cholesterol (TC), total triglyceride (TG), high density lipoprotein-cholesterol (HDL-C), low density lipoprotein-cholesterol (LDL-C), C reactive protein (CRP) and high sensitive CRP (hsCRP) were determined before PCI and at time of re-angiography. RESULTS: The levels of CRP and hsCRP before PCI in restenosis group were higher than those with no restenosis (CRP: median = 3.61 mg/L and 2.86 mg/L respectively, hsCRP: median = 1.56 mg/L and 0.89 mg/L respectively, P < 0.05). There was also difference between two groups in CRP levels at post-PCI follow-ups (median = 1.92 mg/L and 1.14 mg/L respectively, P < 0.05). The rate of restenosis in patients with hsCRP > 2 mg/L before PCI was higher than that in patients with hsCRP < or = 2 mg/L (Chi(2) = 4.32, P < 0.05). Logistic regression showed that the risk of restenosis markedly increased in patients with hsCRP > 2 mg/L (OR = 1.89, 95% CI 1.031-3.465). During the follow-up angiography the levels of TC, LDL-C and non-HDL-C were higher in lesion progression group than those in control group [TC (4.62 +/- 1.14) mmol/L and (4.26 +/- 1.01) mmol/L, LDL-C (2.51 +/- 0.93) mmol/L and (2.25 +/- 0.75) mmol/L, non-HDL-C (3.52 +/- 1.12) mmol/L and (3.20 +/- 0.98) mmol/L, respectively, P < 0.05). CONCLUSION: Inflammation state before and after PCI are the risk factors for in-stent restenosis, while the levels of TC, LDL-C and non-HDL-C are the important risk factors for other coronary lesion progression. Secondary prevention should be long-term emphasized and strengthened after PCI.

Different impacts of C-reactive protein and lipid profile on coronary lesions following a percutaneous coronary intervention.

OBJECTIVE: In-stent restenosis (ISR) and lesion progression are major obstacles for a percutaneous coronary intervention (PCI). Although previous studies have suggested that inflammation and lipid profile may be involved in those pathophysiological events, it remains controversial to date. The aim of the present study was to investigate the impacts of inflammation and lipid profile on both ISR and lesion progression in patients receiving PCI and scheduled follow-up. METHODS: A retrospective analysis of 513 patients was performed in patients who underwent PCI and received coronary angiography again at an average of 7 months. The data of lipid profile and C-reactive protein (CRP) at both pre-PCI and follow-up were analyzed in patients with 94 ISR group and 65 lesion progression (progression group) alone, which was compared with 307 patients with neither ISR nor lesion progression (control group). RESULTS: CRP levels at pre-PCI in the ISR group were higher than those in the control group (P<0.05). The multivariate analysis indicated that the CRP levels at both pre-PCI and follow-up were significantly correlated with ISR [odds ratio (OR)=1.095, 95% confidence interval (CI) 1.005-1.194 for pre-PCI, OR=1.156, 95% CI 1.054-1.267 for follow-up, P<0.05, respectively]. When the cut-off of CRP was 2 mg/l, logistic regression analysis suggested an increased risk of ISR in patients with greater than 2 mg/l (OR=1.89, 95% CI 1.031-3.465) at pre-PCI CRP. The levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and non-high-density lipoprotein cholesterol (non-HDL-C) at follow-up in the progression group were higher than those in the control group (P<0.05, respectively). Logistic regression showed that the risk for lesion progression was associated with the concentrations of TC, LDL-C, and non-HDL-C (P<0.05). CONCLUSION: The levels of pre-PCI CRP were strongly associated with ISR, whereas diabetes, serum levels of TC, LDL-C, and non-HDL-C were significantly correlated with coronary lesion progression.