P193	Inflammatory markers and restenosis after coronary stenting. Effects of statins.
I.Raimbekova, M.Ezhov, A.Sumarokov, A.Samko, V.Masenko, V.Naumov
Cardiology Research Complex, Moscow, RU.

The aim of our prospective study was to evaluate the association of inflammatory markers with restenosis after elective coronary stenting and effect of statins on their concentrations. Methods. We have examined 42 patients (37 men, 5 women, mean age 57±8 years) with stable angina pectoris and stenosis >70% in at least one of major coronary arteries. All patients passed through successful coronary stenting with Bx Velocity stent (Cordis, Johnson & Johnson, USA). The exclusion criteria were acute infections or any operation no less than one month prior to stenting. During the first year after coronary angioplasty all patients were invited to perform clinical examination including treadmill-test and repeat measurement of the following serum levels: C-reactive protein (CRP), interleukin (IL) 6, IL 10, tumor necrosis factor α (TNFα), transforming growth factor β (TGFβ). After angioplasty 29 patients took atorvastatin or simvastatin. Results. At follow-up 22 patients had positive exercise test and/or symptoms of angina pectoris. All they were subjected to repeat coronary angiography: 11 of 22 patients had in-stent restenosis. The remainder of the patients (11 with no angiographic restenosis and 20 asymptomatic patients) formed the group without restenosis. There was no difference in classic atherosclerosis risk factors, between the groups. CRP was significantly higher at baseline in patients with restenosis: 6.2±9.1 vs 2.4±3.0 mg/l, p=0.05. Concentrations of IL 10, TNFα, TGFβ were comparable between the groups at baseline and follow-up. At follow-up serum IL-6 was significantly higher in patients with restenosis: 4.4±6.6 versus 0.7±1.3 ng/ml in patients without restenosis, p=0.006. On statins there was lower rate of restenosis: 14% versus 54% in patients without statins (p=0.01). It could be associated with significant decreasing concentrations of CRP (from 4.5±5.0 mg/l to 2.4±2.5 mg/l, p<0.05) and IL 6 (from 4.1±7.4 pg/ml to 1.0±1.8 pg/ml, p=0.02). Conclusion. C-reactive protein and interleukin 6 levels are higher in patients with restenosis after coronary stenting, and decreasing of their concentrations with statins could be associated with lower rate of restenosis.

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