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Coronary aspirate TNFα reflects saphenous vein bypass graft restenosis risk in diabetic patients

DOI: 10.1186/1475-2840-12-12

Keywords: Coronary disease, Diabetes mellitus, Ischemia, TNFα, Vasoconstriction

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Abstract:

SVG plaque volume and composition were analyzed using intravascular ultrasound before stent implantation. Percent diameter stenosis was determined from quantitative coronary angiography before, immediately after and 6?months after stent implantation. Coronary aspirate was retrieved during stent implantation and divided into particulate debris and plasma. Total calcium, several vasoconstrictors, and tumor necrosis factor (TNF)α in particulate debris and coronary aspirate plasma were determined.Patients with and without DM had similar plaque volume, but larger necrotic core and greater particulate debris release in patients with than without DM (20.3±2.7 vs. 12.7±2.6% and 143.9±19.3 vs. 75.1±10.4?mg, P<0.05). The TNFα concentration in particulate debris and coronary aspirate plasma was higher in patients with than without DM (15.9±6.6 vs. 5.1±2.4 pmol/mg and 2.2±0.7 vs. 1.1±0.2 pmol/L, P<0.05), whereas total calcium and vasoconstrictors were not different. Patients with DM had a greater percent diameter stenosis 6?months after stent implantation than those without DM (22.17±5.22 vs. 6.34±1.11%, P<0.05). The increase in TNFα immediately after stent implantation correlated with restenosis 6?months later (r=0.69, P<0.05).In diabetics, particulate debris and coronary aspirate plasma contained more TNFα, which might reflect the activity of the underlying atherosclerotic process.URL: http://www.clinicaltrials.gov/ct2/results?term=NCT01430884 webcite; unique identifier: NCT01430884Interventional plaque rupture induces the release not only of particulate debris, but also of soluble vasoconstrictor, thrombogenic and inflammatory substances from the lesion. Both, particulate debris as well as soluble substances, contribute to impair microvascular coronary perfusion [1,2] with typical consequences: microinfarcts with a subsequent inflammatory reaction [3], arrhythmias, contractile dysfunction, and impaired coronary reserve [4]. We have previously reported the release of serotoni

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