Release of TNF-alpha during stent implantation into saphenous vein aortocoronary bypass grafts and its relation to plaque extrusion and restenosis

Am J Physiol Heart Circ Physiol. 2007 May;292(5):H2295-9. doi: 10.1152/ajpheart.01116.2006. Epub 2007 Jan 5.

Abstract

The reduction in plaque volume during stent implantation is associated with the release of particulate debris and plaque-derived soluble substances. We studied the potential release of the proinflammatory cytokine TNF-alpha into the coronary circulation and whether such release is related to the reduction in plaque volume and, possibly, a predictor for restenosis. In 18 male patients (n = 24 stents) with severe stenosis in a saphenous vein aortocoronary bypass graft (SVG), we used a distal balloon occlusion-aspiration device during stent implantation. The aspirate TNF-alpha levels were determined before and after stent implantation and related to the angiographic and intravascular ultrasound-assessed severity of stenosis and restenosis. We found that TNF-alpha is, indeed, released into the aspirate of stented SVG (9 +/- 1 and 28 +/- 3 pg/ml before and after stent implantation, respectively, P < 0.0001) and that such release is related to the reduction in plaque volume (r = 0.88, P < 0.0001) and associated with restenosis after 5 mo (r = 0.71, P = 0.001). The periprocedural release of plaque-derived TNF-alpha possibly represents the amount and activity of the atherosclerotic process and might be a predictor for restenosis.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Atherosclerosis / metabolism*
  • Atherosclerosis / surgery*
  • Blood Vessel Prosthesis / adverse effects
  • Coronary Artery Bypass / adverse effects*
  • Graft Occlusion, Vascular / etiology*
  • Graft Occlusion, Vascular / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Saphenous Vein / metabolism*
  • Saphenous Vein / transplantation
  • Stents / adverse effects*
  • Treatment Outcome
  • Tumor Necrosis Factor-alpha / metabolism*

Substances

  • Tumor Necrosis Factor-alpha