Cytokine response after percutaneous coronary intervention in stable angina: Effect of selective glycoprotein llb/llla receptor antagonism
Cytokine response after percutaneous coronary intervention in stable angina: Effect of selective glycoprotein llb/llla receptor antagonism
复制标题
DOI：
10.1067/mhj.2003.65
复制
发表时间：
2003-04-01
影响因子：
4.8
通讯作者：
Voelker, W
中科院分区：
文献类型：
--
作者：
Bonz, AW;Lengenfelder, B;Voelker, W
背景 目前尚不清楚经皮冠状动脉介入治疗 (PCI) 后糖蛋白 IIb/IIIa 受体抑制对炎症标志物的调节是否是由与 α(v)β(3) 和 α(M)β(2) 受体相互作用引起的，还是与 PCI 期间的缺血事件相关。本研究调查了选择性非急性 PCI 后的炎症特征，以及糖蛋白 IIb/IIIa 受体拮抗剂替罗非班是否以及如何调节炎症。方法 采用酶联免疫测定法分析接受围术期和介入治疗后安慰剂 (n = 46) 或替罗非班输注 (n = 50) 的患者的炎症参数（C 反应 I 蛋白 [CRP]、白细胞介素 1 [IL-1]、白细胞介素 6 [IL-6] 和肿瘤坏死因子 α [TNF-α]）的时程。在择期 PCI 之前和之后 30 分钟、2.5 小时、6.5 小时、12 小时、24 小时和 48 小时收集样本。结果 在分析的炎症标志物中，TNF-α、IL-6 和 CRP 水平显着升高。然而，与 PCI 前水平相比，PO 后给予安慰剂的患者和接受替罗非班治疗的患者的后一种标记物遵循个体时间进程 (P < .01)，安慰剂组和替罗非班治疗组之间没有显着差异。然而，亚组分析显示，PCI 后肌钙蛋白 T 阳性患者与肌钙蛋白 T 阴性患者的 TNF-α、IL-6 和 CRP 水平存在显着差异。 结论 选择性糖蛋白 IIb/IIIa 受体拮抗剂替罗非班的给药对择期 PCI 后的炎症状况没有直接影响。炎症特征的变化仅与介入后肌钙蛋白的存在或不存在相关。
Background It is unclear whether modulation of inflammatory markers by glycoprotein IIb/IIIa receptor inhibition after percutaneous coronary intervention (PCI) is caused by an interaction with the alpha(v)beta(3) and alpha(M)beta(2) receptor or it correlates with ischemic events during PCI. This study investigates the inflammatory profile after elective, nonacute PCI and whether and how administration of the glycoprotein IIb/IIIa receptor antagonist tirofiban modulates the. postinterventional inflammatory myocardial response.Methods The time course of inflammatory parameters (C-reactive I protein [CRP], interleukin-1 [IL-1], interleukin-6 [IL-6], and tumor necrosis factor alpha [TNF-alpha]) of patients receiving peri- and pcstinterventional placebo (n = 46) or tirofiban infusion (n = 50) was analyzed by use of enzyme-linked immuno assays. Samples were collected before and 30 minutes, 2.5 hours, 6.5 hours, 12 hours, 24 hours, and 48 hours after elective PCI.Results Among the inflammatory markers analyzed, TNF-alpha, IL-6,,and CRP levels increased significantly. However, the latter markers followed individual time courses in patients given placebo and patients treated with tirofiban after PO, compared with pre-PCI levels (P < .01), with no significant differences between the placebo and tirofiban-treated groups. However, by subgroup analysis, significant differences were revealed in TNF-alpha, IL-6, and CRP levels of patients who were troponin T-positive versus patients who were troponin T-negative after PCI.Conclusions The administration of the selective glycoprotein IIb/IIIa receptor antagonist tirofiban has no direct impact on the inflammatory profile after elective PCI. Change of the inflammatory profile was only related to the presence or absence of postinterventional troponin.