The impact of drug eluting stents on the co-release of interleukin-6 in patients with stable angina

TL;DR

This study shows that drug-eluting stents cause a rapid rise in interleukin-6, a key inflammatory marker, in patients with stable angina.

Contribution

The study provides new evidence on the acute inflammatory response to drug-eluting stents in stable angina patients.

Findings

IL-6 levels significantly increased immediately and 24 hours after stent placement.

Males showed significant IL-6 increases after stent placement.

Statin use reduced baseline IL-6 but had less effect after stent insertion.

Abstract

Background: Drug-eluting stents represent an important revolution in the treatment of coronary artery disease. However, the mechanical trauma of stent deployment can trigger vascular injury and inflammatory cytokine cascades, potentially precipitating in-stent restenosis. The release of cytokines is not firmly established in patients with stable angina.

Aims: To evaluate the acute effect of drug-eluting stents on the acute inflammatory response in patients with stable angina by quantifying interleukin-6 levels.

Methods and materials: A single-centre exploratory study was conducted on 13 patients with stable angina undergoing elective angioplasty. Arterial blood samples were collected before angioplasty and directly after angioplasty. Additionally, venous blood samples were collected 24 h post-angioplasty. Concentrations of interleukin-6 were analysed to assess changes in the acute inflammatory response.

Results: IL-6 concentration significantly increased immediately after stent placement (5.95 ± 0.49 pg/ml, p  =   < 0.05) and 24 h post-stent placement (8.96 ± 1.16 pg/ml, p  =   < 0.01). Gender-based analysis indicated significant increases in IL-6 levels in males post-stent placement (5.94 ± 0.08 pg/ml, p  =   < 0.05) and 24 h post-stent placement (7.27 ± 0.56 pg/ml, p  =   < 0.01). Statin medication significantly reduced IL-6 expression in patients at baseline (3.27 ± 0.71 pg/ml versus 5.44 ± 0.18 pg/ml, p  =   < 0.05), but this distinction diminished rapidly after stent insertion, resulting in comparable IL-6 levels at 24 h post-stent insertion in both groups.

Conclusion: Interleukin-6 levels markedly increased immediately after coronary stenting, suggesting its role as an early initiator of the inflammatory response to coronary stenting. While limited by sample size, it lays the groundwork for larger, more comprehensive research to optimize drug-eluting stents outcomes and inflammatory management.

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