Changes And Significances Of Serum Interleukin-6 And C-reactive Protein Levels Pre-and Post-intervention In The Patients With Direct Coronary Stenting

Objective The serum levels of interleukin 6 (IL-6) and C-reactive protein (CRP) in coronary stenting with dilation and direct coronary stenting were studied before and after operation. The mechanism underlying the early inflammatory response post-coronary stenting and the relationship between the serum interleukin 6 ,C-reactive protein and the restenosis during long-term follow-up were investigated.Methods Fifty patients, who underwent successfully coronary stenting from February,2002 to March,2003, were divided into Group A (coronary stenting with pre-dilation),and Group B (direct coronary stenting). Samples of peripheral serum in both groups were obtained to determine the serum C-reactive protein (CRP) levels before and 6h, 48h, and 7d after operation. The serum interleukin 6 (IL-6) (stored at -20C) was determined at the selected time by enzyme-linked immunosorbent assay (ELISA), and the observed figures were statistically analyzed by T-test.Results(1) The levels of IL-6 6h after operation and CRP 48hafter operation in the two groups were significant higher than those before the operation(P<0.00 1) (IL-6: 12. 26 ± 3. 29pg/ml vs 5.43±2.14 pg/ml in Group A and 9. 33 ± 2. 42pg/ml vs 5. 07 ± 1. 87pg/ml in Group B; CRP: 15.03 ± 3. 15mg/l vs 6.29 ± 1.89mg/l in Group A and 11.67 ± 2.34mg/l vs 6.46± 1.47mg/l in Group B). There was no difference in IL-6 and CRP before and 7d after operation(P>0.05). (2) The peakvalues of IL-6 and CRP in group A were significant decreased compared with those in group B (IL-6: 9.33±2.42 pg/l vs 12.26 ± 3.29 pg/ml; CRP: 11.67 ± 2.34mg/l vs 15. 03 ± 3. 15mg/l)(P<0.01). (3) The 6-month follow-up indicated that the restenosis occurrence had difference in the two groups(Group A: 26.3% vs Group B: 4.5%) ( P<0.05 ) .Conclusion The IL-6 and CRP are the early inflammation sensitive indexes after coronary stenting. In comparison with pre-dilation coronary stenting, direct coronary stenting can lessen the mechanical damage to vascular wall , lower the seriousness of causing vasculitis and reduce the restenosis occurrence after stenting. It provides a reliable experimental basis for the popular clinical application of direct coronary stenting in the patients with coronary disease.