Sensitive C-reactive protein, serum amyloid A, and neopterin with angiographic in stent restenosis

Vascular inflammation induced by percutaneous coronary intervention (PCI) has an important role in the pathogenesis of in-stent restenosis (ISR). Previous studies have addressed that serum amyloid A (SAA), high sensitive C-reactive protein (hs-CRP), neopterin, and matrix metalloproteinase-9 (MMP-9) play an important role in inflammatory process of development of ISR.

We aimed to investigate the relationship of preprocedural levels of these inflammatory markers and the development of ISR.

This was a prospective-case controlled study. 76 of 123 screened consecutive patients with stable angina who underwent coronary angiography, were scheduled for bare metal stent (BMS) placement. Control angiography was performed 6–12 months after the index intervention.

ISR was documented in the of 23 patients (30%), it was not documented in the remaining 53 patients (70%). The basal serum neopterin level was 2.32 ± 1.27 ng/ml and 1.67 ± 0.89 ng/ml, hs-CRP level was 9.16 ± 8.73 mg/L and 5.85±5.59 mg/L, the serum basal SAA level was 18.28 ±39.84 ng/ml and 12.77±23.67 ng/ml, the serum basal MMP-9 level was 75.06 ±35.05 ng/ml and 66.78±38.32 ng/ml, in patients with and without restenosis, respectively. Neopterine and hs-CRP levels exhibited a significant association with the ISR (p:0.01, p:0.04, respectively), SAA and MMP-9 levels did not (p:0.46, p:0.36, respectively).

In present study, serum baseline neopterin and hs-CRP concentrations were predictive for the development of ISR. We also observed a significant correlation between the neopterin and hs-CRP in restenosis group.