Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis
The introduction of drug-eluting stents (DES) into clinical practice has led to a significant reduction in the incidence of in-stent restenosis (ISR) compared to implantation of bare metal stents. However, in 2-4% of cases, the development of angiographic restenosis is observed. Vascular Endothelial...
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«SILICEA-POLIGRAF» LLC
2024-06-01
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| Series: | Кардиоваскулярная терапия и профилактика |
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| Online Access: | https://cardiovascular.elpub.ru/jour/article/view/3904 |
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| author | V. V. Tishko E. I. Senkina M. E. Meshkova A. N. Shishkevich I. A. Menkova S. E. Bednova V. V. Tyrenko |
| author_facet | V. V. Tishko E. I. Senkina M. E. Meshkova A. N. Shishkevich I. A. Menkova S. E. Bednova V. V. Tyrenko |
| author_sort | V. V. Tishko |
| collection | DOAJ |
| description | The introduction of drug-eluting stents (DES) into clinical practice has led to a significant reduction in the incidence of in-stent restenosis (ISR) compared to implantation of bare metal stents. However, in 2-4% of cases, the development of angiographic restenosis is observed. Vascular Endothelial Growth Factor-A (VEGF-A) promotes early endothelialization of the stented segment, but in some cases can promote progressive neointimal growth due to proinflammatory effects.Aim. To evaluate the influence of plasma VEGF-A level on ISR after DES implantation.Material and methods. We prospectively examined 49 patients who were implanted with DES due to stable coronary artery disease with ischemia-related arterial stenosis >70% according to a stress test, as well as with a fractional flow reserve <0,8. Plasma VEGF-A level was assessed immediately before the procedure and 24 hours after it. The follow-up period was 11±4 months from the moment of intervention. Subsequently, all study participants underwent repeated coronary angiography to determine whether they had angiographic ISR and to identify patients at risk of recurrent angina pectoris. In 9 patients (18% of participants), angiographic ISR was recorded in the long-term period.Results. The groups of patients with and without long-term restenosis were comparable in terms of initial VEGF-A levels: 481 (259; 674) and 560 (339; 766) pg/ml, respectively (p>0,05). Within 24 hours after stent implantation, a significant increase in VEGF-A level was found in patients who subsequently demonstrated angiographic ISR as follows: from 476 (267; 602) to 1117 (1089; 1573) pg/ml (p<0,05). A positive moderate correlation was established between the plasma VEGF-A content 24 hours after stent implantation and angiographic ISR in the long-term period (r=0,55; p<0,001).Conclusion. Initial plasma VEGF-A levels are not associated with angiographic ISR. Moreover, a sharp increase in VEGF-A level f within 24 hours after coronary stenting is associated with drug-eluting ISR. |
| format | Article |
| id | doaj-art-34639cdab360475b8760f87d96344d2f |
| institution | Kabale University |
| issn | 1728-8800 2619-0125 |
| language | Russian |
| publishDate | 2024-06-01 |
| publisher | «SILICEA-POLIGRAF» LLC |
| record_format | Article |
| series | Кардиоваскулярная терапия и профилактика |
| spelling | doaj-art-34639cdab360475b8760f87d96344d2f2025-08-20T03:35:51Zrus«SILICEA-POLIGRAF» LLCКардиоваскулярная терапия и профилактика1728-88002619-01252024-06-0123510.15829/1728-8800-2024-39042973Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosisV. V. Tishko0E. I. Senkina1M. E. Meshkova2A. N. Shishkevich3I. A. Menkova4S. E. Bednova5V. V. Tyrenko6Kirov Military Medical AcademyKirov Military Medical AcademyKirov Military Medical AcademyKirov Military Medical AcademyKirov Military Medical AcademyKirov Military Medical AcademyKirov Military Medical AcademyThe introduction of drug-eluting stents (DES) into clinical practice has led to a significant reduction in the incidence of in-stent restenosis (ISR) compared to implantation of bare metal stents. However, in 2-4% of cases, the development of angiographic restenosis is observed. Vascular Endothelial Growth Factor-A (VEGF-A) promotes early endothelialization of the stented segment, but in some cases can promote progressive neointimal growth due to proinflammatory effects.Aim. To evaluate the influence of plasma VEGF-A level on ISR after DES implantation.Material and methods. We prospectively examined 49 patients who were implanted with DES due to stable coronary artery disease with ischemia-related arterial stenosis >70% according to a stress test, as well as with a fractional flow reserve <0,8. Plasma VEGF-A level was assessed immediately before the procedure and 24 hours after it. The follow-up period was 11±4 months from the moment of intervention. Subsequently, all study participants underwent repeated coronary angiography to determine whether they had angiographic ISR and to identify patients at risk of recurrent angina pectoris. In 9 patients (18% of participants), angiographic ISR was recorded in the long-term period.Results. The groups of patients with and without long-term restenosis were comparable in terms of initial VEGF-A levels: 481 (259; 674) and 560 (339; 766) pg/ml, respectively (p>0,05). Within 24 hours after stent implantation, a significant increase in VEGF-A level was found in patients who subsequently demonstrated angiographic ISR as follows: from 476 (267; 602) to 1117 (1089; 1573) pg/ml (p<0,05). A positive moderate correlation was established between the plasma VEGF-A content 24 hours after stent implantation and angiographic ISR in the long-term period (r=0,55; p<0,001).Conclusion. Initial plasma VEGF-A levels are not associated with angiographic ISR. Moreover, a sharp increase in VEGF-A level f within 24 hours after coronary stenting is associated with drug-eluting ISR.https://cardiovascular.elpub.ru/jour/article/view/3904percutaneous coronary angioplastydrug-eluting stent(s)in-stent restenosisvascular endothelial growth factor-a |
| spellingShingle | V. V. Tishko E. I. Senkina M. E. Meshkova A. N. Shishkevich I. A. Menkova S. E. Bednova V. V. Tyrenko Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis Кардиоваскулярная терапия и профилактика percutaneous coronary angioplasty drug-eluting stent(s) in-stent restenosis vascular endothelial growth factor-a |
| title | Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis |
| title_full | Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis |
| title_fullStr | Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis |
| title_full_unstemmed | Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis |
| title_short | Role of early increase in vascular endothelial growth factor-A levels after coronary stenting in the development of drug-eluting in-stent restenosis |
| title_sort | role of early increase in vascular endothelial growth factor a levels after coronary stenting in the development of drug eluting in stent restenosis |
| topic | percutaneous coronary angioplasty drug-eluting stent(s) in-stent restenosis vascular endothelial growth factor-a |
| url | https://cardiovascular.elpub.ru/jour/article/view/3904 |
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