Effect of oral sirolimus therapy on inflammatory biomarkers following coronary stenting

View/ Open
Date
2010-08-01Author
Rosa, Werther Clay Monico [UNIFESP]
Campos, Alexandre Holthausen [UNIFESP]
Lima, Valter Correia [UNIFESP]
Type
ArtigoISSN
0100-879XIs part of
Brazilian Journal of Medical and Biological ResearchDOI
10.1590/S0100-879X2010007500071Metadata
Show full item recordAbstract
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.
Citation
Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 43, n. 8, p. 786-793, 2010.Keywords
Inflammation mediatorsOral sirolimus
Percutaneous coronary intervention
Coronary artery angioplasty
Coronary restenosis
Immunosuppression
Sponsorship
Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Collections
- EPM - Artigos [17701]