Effect of oral sirolimus therapy on inflammatory biomarkers following coronary stenting

Effect of oral sirolimus therapy on inflammatory biomarkers following coronary stenting

Author Rosa, Werther Clay Monico Autor UNIFESP Google Scholar
Campos, Alexandre Holthausen Autor UNIFESP Google Scholar
Lima, Valter Correia Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Universidade Federal do Espírito Santo Hospital Universitário Cassiano Antonio de Morais Disciplina de Cardiologia
Abstract We studied the effect of oral sirolimus, administered to prevent and treat in-stent restenosis (ISR), on the variation of serum levels of inflammatory markers following coronary stenting with bare metal stents. The mean age of the patients was 56 ± 13 years, 65% were males and all had clinically manifested ischemia. Serum levels of high sensitivity C-reactive protein (hs-CRP) concentration were determined by chemiluminescence and serum levels of all other biomarkers by ELISA. One group of patients at high risk for ISR received a loading oral dose of 15 mg sirolimus and 5 mg daily thereafter for 28 days after stenting (SIR-G). A control group (CONT-G) was submitted to stenting without sirolimus therapy. The increase in hs-CRP concentration was highest at 24 h after stenting in both groups. A significant difference between SIR-G and CONT-G was observed at 4 weeks (-1.50 ± 5.0 vs -0.19 ± 0.4, P = 0.008) and lost significance 1 month after sirolimus discontinuation (-1.73 ± 4.3 vs -0.01 ± 0.7, P = 0.0975). A continuous fall in MMP-9 concentration was observed in SIR-G, with the greatest reduction at 4 weeks (-352.9 ± 455 vs +395.2 ± 377, P = 0.0004), while a positive variation was noted 4 weeks after sirolimus discontinuation (227 ± 708 vs 406.2 ± 472.1, P = 0.0958). SIR-G exhibited a higher increase in P-selectin after sirolimus discontinuation at week 8 (46.1 ± 67.9 vs 5.8 ± 23.7, P = 0.0025). These findings suggest that the anti-restenotic actions of systemic sirolimus include anti-proliferative effects and modulation of the inflammatory response with inhibition of adhesion molecule expression.
Keywords Inflammation mediators
Oral sirolimus
Percutaneous coronary intervention
Coronary artery angioplasty
Coronary restenosis
Language English
Sponsor Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
Grant number FAPESP: 03/02946-7
Date 2010-08-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 43, n. 8, p. 786-793, 2010.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 786-793
Origin http://dx.doi.org/10.1590/S0100-879X2010007500071
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000283261800012
SciELO ID S0100-879X2010000800012 (statistics in SciELO)
URI http://repositorio.unifesp.br/handle/11600/5879

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