The predictive value of plasma TGF-β levels in in-stent restenosis

Yıl 2023, Cilt: 9 Sayı: 2, 104 - 110, 30.08.2023

Hakan Tibilli , Osman Kayapınar , Hakan Özhan

https://doi.org/10.30569/adiyamansaglik.1224881

Öz

Aim: In-stent restenosis (ISR) is one of the most important cause of both early and late morbidity in coronary artery disease (CAD). We planned to investigate whether this molecule could predict future ISR or not.
Materials and Methods: 82 patients who has prior PCI history and is scheduled for coronary angiography for any reason is included in the study. ISR is defined as ≥%50 narrowing inside the stent. Plasma TGF- β levels are studied in all patients.
Results: We found no significant correlation between ISR and TGF-β levels (p=0.754). In multivariate regression analysis there is a negative corelation between ISR and target vessel diameter, and positive corelation between ISR and right coronary artey (RCA) lesions.
Conclusion: This study has shown that there is no attribute of TGF- β in predicting ISR.

Anahtar Kelimeler

In-stent restenosis, TGF-β, Coronary artery disease, Percutaneous coronary implantation

Stent-içi restenozu öngörmede serum TGF-β düzeylerinin etkinliği

Öz

Amaç: Stent-içi restenoz (SİR), stent implantasyonu sonrası erken ve geç dönem morbiditenin en önemli nedenlerinden birisidir. Biz bu çalışmada serum dönüştürücü büyüme faktörü-β (TGF-β) düzeyinin gelişebilecek SİR’i ön gördürüp gördürmeyeceğini araştırmayı planladık.
Gereç ve Yöntem: Daha önce peruktan koroner girişim (PKG) uygulanmış ve herhangi bir endikasyonla koroner anjiografi (KAG) planlanmış toplam 82 hasta çalışmaya dahil edildi. SİR; stent içinde ≥%50 daralma olması şeklinde tanımlandı. 34 hastada restenoz saptanırken 48 hastada anjiografik olarak kritik lezyon saptanmadı. Tüm hastalarda plazma TGF- β düzeyi ölçüldü.
Bulgular: SİR ile TGF- β düzeyi arasında istatistiksel olarak anlamlı bir ilişki saptanmadı (p=0,754). Yapılan alt grup çok değişkenli regresyon analizinde hedef damar çapı ile SİR arasında negatif, sağ koroner arter lezyonları ile SİR arasında pozitif korelasyon saptandı.
Sonuç: Bu çalışma herhangi bir zamanda bakılan TGF-β’nın SİR öngördürücü bir özelliği olmadığını ortaya koymuştur

Anahtar Kelimeler

Stent-içi restenoz, TGF- β, Koroner arter hastalığı, Perkütan koroner girişim

Destekleyen Kurum

Çalışmayı maddi olarak destekleyen kişi/kuruluş yoktur.

Kaynakça

• TEKHARF; Oniki Yıllık İzleme Deneyimine Göre Türk Erişkinlerinde Kalp Sağlığı. Prof. Dr. Altan Onat, Prof. Dr. Vedat Sansoy, Prof. Dr. İnan Soydan, Prof. Dr. Lale Tokgözoğlu, Prof. Dr. Kamil Adalet. Argos İletişim Hizmetleri Reklamcılık ve Ticaret Anonim Şirketi. Temmuz 2003, İstanbul.
• Dinc Asarcikli L, Kis M, Koza Y, Oguz D, Güvenc TS, Tosun V, Inci S, Zoghi M; CVSCORE-TR investigators. Cardiovascular risk unawareness is common in individuals admitting to cardiology outpatient clinics in Turkey: the CVSCORE-TR study. Scand Cardiovasc J. 2021 Apr;55(2):82-90.
• Hannan EL, Cozzens K. Reporting of Percutaneous Coronary Interventions Site-Specific Mortality. JAMA Cardiol. 2021 Nov 1;6(11):1343.
• Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, al. A 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2022 Jan 18;145(3):e4-e17.
• Kawai K, Virmani R, Finn AV. In-Stent Restenosis. Interv Cardiol Clin. 2022 Oct;11(4):429-443.
• Kuntz SH, Torii S, Jinnouchi H, Cornelissen A, Sakamoto A, Sato Y, Kutyna M, Romero ME, Lejay A, Schwein A, Bonnin E, Finn AV, Chakfé N, Virmani R. Pathology and Multimodality Imaging of Acute and Chronic Femoral Stenting in Humans. JACC Cardiovasc Interv. 2020 Feb 24;13(4):418-427.
• Grainger DJ. Transforming growth factor beta and atherosclerosis: so far, so good for the protective cytokine hypothesis. Arterioscler Thromb Vasc Biol. 2004;24(3):399-404
• Alban D. Et al. ‘Inflammatory response after intervention assessed by serial C-reactive protein measurements correlates with restenosis in patients treated with coronary stenting’ Am Heart J 2005; 150: 344-50.
• Schober A. Hoffman R. et al. Peripheral CD34+ cells and the risk of in-stent restenosis in patients with coronary heart disease. Am J Cardiol 2005; 96:1116–1122.
• DiCorleto PE. Cellular mechanisms of atherogenesis. Am J Hypertens.1993;6:314S–318S.
• Wilensky RL, Pyles JM, Fineberg N. Increased thrombin activity correlates with increased ischemic event rate after percutaneous trans-luminal coronary angioplasty: lack of efficacy of locally delivered urokinase. Am Heart J. 1999;138:319–325.
• Takamori N, Azuma H, et al. High plasma heparin cofactor II activity is associated with reduced incidence of in-stent restosis after percutaneous coronary implantation. Circulation. 2004;109:481-486.
• Lowe HC., Oesterle SN, Khachigian LM. Coronary in- stent restenosis: current status and future strategies. J Am Coll Cardiol 2002;39:183-193.
• Schnyder G, Roffi M, Flammer Y, et al. Effect of homocysteine-lowering therapy with folic acid, vitamin B 12, and vitamin B 6 on clinical outcome after percutaneous coronary intervention: the Swiss Heart study: a randomized controlled trial. JAMA. 2002;288:973–979.
• Frystyk J, Ledet T, Moller N, et al. Cardiovascular disease and insulin-like growth factor I. Circulation. 2002;106:893–895
• Novotny L, Vitek L: Inverse relationship between serum bilirubin and atherosclerosis in men: a meta-analysis of published studies. Exp Biol Med (Maywood), 2003; 228: 568-571
• Vitek L, Jirsa M, Brodanova M, Kalab M, Marecek Z, Danzig V, Novotny L, Kotal P: Gilbert syndrome and ischemic heart disease: a protective effect of elevated bilirubin levels. Atherosclerosis, 2002; 160: 449-456.
• Yingzhu C, Xianxian C, et al. Protective and Indicating Effect of Indirect Bilirubin in Intracranial or Extracranial Artery Atherosclerotic Stenosis Progresses. J Atheroscler Thromb, 2011; 18:574-583.
• Quyyumi AA, Dakak N, Andrews NP et al. Nitric oxide activity in the human coronary circulation. Impact of risk factors for coronary atherosclerosis. J Clin Invest 1995; 95:1747–55.
• Takemoto M, Egashira K, Usui M et al. Important role of tissue angiotensin-converting enzyme activity in the patho-genesis of coronary vascular and myocardial structural changes induced by long-term blockade of nitric oxide synthesis in rats. J Clin Invest 1997; 99: 278–87.
• Gomma AH., Elrayess MA., et al. The endothelial nitric oxide synthase (Glu298Asp and - 786T>C) gene polymorphisms are associated with coronary in-stent restenosis. Eur Heart J, 2002; 23:1955–1962, doi:10.1053/euhj.2002.3400
• Hudzik B, Szkodzinski J, Romanowski W, Wilczek K, Wojnar R, Lekston A, Polonski L, Zubelewicz-Szkodzinska B. No predictive value of serum interleukin-6 and transforming growth factor-beta1 in identifying patients with a first restenosis, recurrent restenosis or a history of restenosis. Eur Cytokine Netw. 2009;20(3):135-9.
• Szkodzinski J, Blazelonis A, Wilczek K, Hudzik B, Romanowski W, Gasior M, Wojnar R, Lekston A, Polonski L, Zubelewicz-Szkodzinska B. The role of interleukin-6 and transforming growth factor-beta1 in predicting restenosis within stented infarct-related artery. Int J Immunopathol Pharmacol. 2009;22(2):493-500.
• Wang DS, Ganaha F, Kao EY, Lee J, Elkins CJ, Waugh JM, Dake MD. Local Stent-Based Release of Transforming Growth Factor-β1 Limits Arterial In-Stent Restenosis. J Lab Autom. 2016;21(2):305-11.
• Trzeciak P, Hawranek M, Ostrowska Z, Wiczkowski A, Poloński L, Gąsior M. The Relationships between Polymorphisms in Genes Encoding the Growth Factors TGF-β1, PDGFB, EGF, bFGF and VEGF-A and the Restenosis Process in Patients with Stable Coronary Artery Disease Treated with Bare Metal Stent. PLoS One. 2016;11(3):e0150500.
• Kis M, Yurdam FS. The relationship between degree of coronary artery stenosis detected by coronary computed tomography angiography and ACEF risk score in patients with chronic coronary syndrome. Ann Saudi Med. 2023 Jan-Feb;43(1):35-41.