Comparison Of Postoperative Inflammatory Response Between Patients With Bioabsorbable Stents And Drug-eluting Stents

Background: Since the first case of coronary interventional procedure, percutaneous coronary intervention has gone through 30 years’ development. From the simple balloon dilatation initially to the drug eluting stent（DES） currently, DES can reduce the incidence of in-stent restenosis by reducing vascular elastic recoil and inhibiting the proliferation and migration of vascular smooth muscle cells. However, the adverse events, such as in-stent restenosis and stent thrombosis are still the problems to be solved. The reason of in-stent restenosis was mainly intimal hyperplasia which is induced by inflammation including polymer-induced local inflammation. Hs-CRP, IL-6, MMP-9 and ET-1 were the common systemic inflammatory response factors, which play an important role in adverse events after stent implantation. Therefore, development of biodegradable stent which has a higher biocompatibility and histocompatibility has become a trend in the future. Currently, bioabsorbable stent was made of new biodegradable polymeric material coating with drugs which could completely be absorbed within 2 years in general, and it is expected to solve the biological compatibility issues completely. However, up to now, there is no comparison of inflammatory reaction between the two kinds of stents.Objectives: To compare the dynamic changes of serum hs-CRP,IL-6,MMP-9,ET-1 after percutaneous coronary intervention, indirectly reflecting whether there exist differences in inflammatory response between DES and bioabsorbable stents. Meanwhile,to investigate the short-term efficacy and safety in clinical applications of bioabsorbable stents.Methods: Continuously collected subjects hospitalized for selective coronary angiography of Xijing Hospital from March 2015 to November 2015.Coronary artery disease belongs to the primary, in situ, single, single lesions.After signing the informed consent, the subjects were then randomized to the experimental group(Neo Vas^TM stent group) and control group（Xience Prime group）. All patients were followed up and the serum hs-CRP, IL-6, MMP- 9 and ET-1 concentrations were detected before surgery,at 24h、1 month 、3 month and 6 month after PCI.Results: A total of 37 patients were selected in this study, including 16 patients in the experimental group and 21 patients in the control group. The clinical characteristics before PCI were similar between the experimental group and control group Patients（P > 0.05）.There was no significant difference in the process of stent implantation（P > 0.05）.Among 6 months’ follow-up,there was no significant difference in the incidence of major adverse cardiovascular events（MACE）,stent thrombosis and severe adverse events between experimental group and control group（P > 0.05）.The concentrations of serum hs-CRP, IL-6 and MMP-9 reached to the peak at 24 h after PCI at both groups,significantly higher than the levels before PCI（P < 0.05）.The concentrations of serum hs-CRP, IL-6 and MMP-9 in the experimental group were lower than the control group at 24 h, 1 month and 3 month after PCI,and the difference was significant statistically（P < 0.05）. At 6 month,there are no difference statistically between the two groups.The level of serum ET-1 reached to the peak at 24 h after PCI. At 24h、1 month and 6 month after surgery, the level of serum ET-1 in the experimental group were higher than the control group, but there was no significant difference（P > 0.05）.Conclusions:1. The bioabsorbable stent group exhibited a lower inflammation reaction compared with drug-eluting stents, which reflected through lower levels of hs-CRP, IL-6 and MMP-9 within postoperative 3 months.2.The 6 month follow-up results showed the short-term efficacy and safety of bioabsorbable stent in the treatment of simple coronary lesion.