Comparison of the Effects of Bare Metal Stents and Drug Eluting Stents on C- Reactive Protein Levels

Abstract

Aim: It's suggested that drug eluting stents (DES) may have systemic anti inflammatory properties and this can play a role in decreased restenosis rates. We aimed to compare bare metal stents (BMS) and DES on their effects on C-reactive protein (CRP) levels, a good marker of systemic inflammation. We also aimed to investigate the relation between the inflammation levels and myonecrosis and adverse cardiac events. Methods: Patients undergoing elective stent implantation were grouped as BMS (n = 70) and DES (n = 42). Basal and 24th hour postprocedural CRP and CKMB levels were measured and the difference (Δ) was compared between the groups. The patients were followed up for adverse cardiac events for one year. Results: Mean age was 62 ± 11 and 75% were males. There was significant CRP rise in both groups at 24 th hour, but the ΔCRP was 2.1 (0.5-6.2) mg/L in BMS and 2.3 (0.2-5.2) mg/L in DES group, the difference wasn't statistically significant (p = 0.703). ΔCKMB and adverse cardiac event rates were similar between the two groups (p = 0.897 and p = 0.785). There was no correlation between ΔCRP and ΔCKMB (r = -0.090 and p = 0.459 for BMS, r = 0.158 and p = 0.318 for DES). The effect of ΔCRP on the incidence of adverse cardiac events was not significant (p = 0.349 for BMS, p = 0.135 for DES). Conclusion: Our findings reveal that patients with BMS and DES implantation exhibit similar grade of systemic inflammation after the procedure. At similar levels of systemic inflammation, the local anti-inflammatory properties of DES can play a role at decreased restenosis rates.