Turk Kardiyol Dern Ars. 2013; 41(8): 675-682 | DOI: 10.5543/tkda.2013.64600

Soluble CD40 ligand release in patients with stable coronary artery disease during elective stent implantation: effect of drug-eluting stent over bare metal stent

Cihan Dündar¹, Filiz Kızılırmak¹, Kürşat Tigen², Akın İzgi¹, Tansu Karaahmet³, Selçuk Pala¹, Vecih Oduncu¹, Ayhan Erkol¹, Mustafa Bulut¹, Cevat Kırma^1
1Department of Cardiology, Kartal Kosuyolu Heart Training and Research Hospital, Istanbul
²Department of Cardiology, Marmara University Faculty of Medicine, Istanbul
³Department of Cardiology, Acibadem University Faculty of Medicine, Istanbul, Turkey

OBJECTIVES
We aimed to determine the effect of drug-eluting stent (DES) implantation on soluble CD40 ligand (sCD40L) levels in patients with stable coronary artery disease undergoing stent replacement.

STUDY DESIGN
Eighty-nine consecutive patients (33 women, 56 men; mean age 61±10 years) with stable coronary artery disease undergoing stent replacement were recruited. Preand post-procedural blood samples were collected for sCD40L analysis, and differences in plasma levels were calculated and expressed as delta sCD40L. Total size and length of implanted stents and pre- and post-dilatation procedures were recorded for each patient, for possible impact on sCD40L release. Patients were followed for one year following procedures for possible adverse cardiac events such as death, myocardial infarction and revascularization.

RESULTS
Forty-nine patients received bare metal stent (BMS) and 40 patients received DES. There were no differences between BMS- and DES-implanted patients in terms of age, stent size and length, and delta sCD40L plasma levels. Delta sCD40L was correlated only with total implanted stent length (r=0.374, p<0.001). Delta sCD40L levels were divided into quartiles for better determination of the procedural parameters that are effective on biomarker release. Total stent length (p=0.008), stent size (p=0.038) and pre-dilatation procedure (p=0.034) were the statistically differing parameters between delta sCD40L quartiles. Although statistically non-significant, all three adverse events were observed in patients with the highest quartile (p=0.179).

CONCLUSION
Procedural sCD40L release did not differ between DES- and BMS-implanted stable coronary artery disease patients. Total implanted stent length, stent size and pre-dilatation procedure were the influential parameters on procedural sCD40L release.

Keywords: Angioplasty, transluminal, percutaneous coronary, biological markers/blood; CD40 ligand/blood; coronary artery disease/ blood; drug-eluting stents; platelet aggregation inhibitors; stents.

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