The Relationship Between Plasma Soluble P-selectin Levels and Restenosis After Coronary Baloon Angioplasty

OBJECTIVE
Coronary interventional procedures are expected to induce soluble P (sP)-selectin , a cell adhesion molecule, release through the local injury on the coronary lesion. The ai m of this study was to evaluate the magnitude of sP-selectin secretioı1 in response to vascular injury after balloon angioplasty (PTCA) and its relationship with restenosis.
METHODS
The study group consis ted of 26 consecutive patients undergoing successful electi ve first PTCA. Patients suffering from any kind of infectious disease and systemic immunological illness or receiving an immune-modulating ınedication were excluded. Fifteen patients (age- and sex-matched) with normal coronaries served as controls. All procedures were performed with the same protocol. Plasma sP-selectin levels were measured before and immediately and 24 hours after the invasive procedure. ELISA method was used for the quantitative laboratory measurement of sPselectin.
RESULTS
sP-selectin levels before the in vas ive procedure were significantly higher when compared to control group and significantly increased 24 hours after PTCA (study group: serially 68±23 ng/ml , 63±2 1 ng/ml, and 133±20 ng/ml; control group 25±7ng/ml). There were no changes in sP-selectin levels immediately after the procedure. During the follow-up period, restenesis developed in 8 patients. The pre- and post 24 hour P-selectin levels were higher in patients who developed restenosis (for baseline values: 84±8 ng/ml vs 59±22 ng/ml, p=0,006;and for 24th hour values ı57±5 ng/ml vs ı20±13 ng/ml , p=O,OOı ) .
CONCLUSION
1. sP-selectin levels are increased in patients with coronary artery disease. 2. PTCA induces a significant rise in sP-selectin levels which may indicare a potential role of this mediator in the response of the vessel wall to PTCA injury. These findings suggest that PTCA triggers an inflammatory response leading to further sP-selectin secretion. 3. Patients in whom restenosis developed had higher levels of pre and post PTCA levels of P-selectin. There might be a relationship between the restenosis and P-selectin levels which is thought to be reflecting a triggering effect.