Submitted on October 12, 2006
Accepted on January 2, 2007
Release of TNF
during stent implantation into saphenous vein aortocoronary bypass grafts and its relation to plaque extrusion and restenosis
Dirk Böse1, Kirsten Leineweber2, Thomas Konorza1, Andreas Zahn3, Martina Bröcker-Preuss4, Klaus Mann5, Michael Haude6, Raimund Erbel6, and Gerd Heusch3*
1 Cardiology, University of Essen, Essen, Germany
2 Pathophysiology, University of Essen, Essen, Germany
3 Essen, Germany; Pathophysiology, University of Essen, Essen, Germany
4 Clinical Chemistry, University of Essen, Essen, Germany
5 Essen, Germany; Clinical Chemistry, University of Essen, Essen, Germany
6 Cardiology, University of Essen, Essen, Germany; Essen, Germany
* To whom correspondence should be addressed. E-mail: gerd.heusch{at}uk-essen.de.
The reduction in plaque volume during stent implantation is associated with the release of particulate debris and plaque-derived soluble substances. We studied the potential release of the pro-inflammatory cytokine tumor necrosis factor-
(TNF) into the coronary circulation and whether such release is related to the reduction in plaque volume and possibly a predictor for restenosis.
In eighteen male patients (=24 stents) with a severe stenosis in their saphenous vein aortocoronary bypass graft (SVG) we used a distal balloon occlusion/aspiration device during stenting. The aspirate TNF levels were determined before and after stenting and related to the angiographic and intravascular ultrasound-assessed severity of stenosis and to restenosis.
We found that TNF is indeed released into the aspirate of stented SVG (TNF in pg/ml, before: 9±1 vs. after stenting: 28±3; with p<0.0001) and that such release is related to the reduction in plaque volume (r=0.88, p<0.0001) and associated with restenosis after five months (r=0.71, p=0.001).
The periprocedural release of plaque-derived TNF possibly represents the amount and activity of the atherosclerotic process and might be a predictor for restenosis.
