Neopterin and Cardiovascular Events Following Coronary Stent Implantation in Patients with Stable Angina Pectoris

Abstract

Aim: Neopterin is an activation marker for monocytes/macrophages. We prospectively investigated the predictive value of plasma neopterin levels on 2-year and long-term cardiovascular events in patients with stable angina pectoris (SAP) undergoing coronary stent implantation.Methods: We studied 123 consecutive patients with SAP who underwent primary coronary stenting (44 patients with bare metal stent: BMS group and 79 with drug-eluting stent: DES group). Plasma neopterin levels were measured on admission using HPLC. Moreover, one frozen coronary artery specimen after DES and three frozen coronary specimens after BMS were obtained by autopsy or endarterectomy, followed by immunohistochemical staining for neopterin.Results: Plasma neopterin levels were significantly higher in patients with cardiovascular events than in those without them (P < 0.001). In subgroup analyses, higher levels of plasma neopterin in patients with cardiovascular events (P < 0.001) and a positive correlation between neopterin levels and late lumen loss after stenting (P = 0.008) were observed in the BMS group but not in the DES group (P = 0.53 and P = 0.17, respectively). In long-term cardiovascular events, multivariate Cox regression analysis identified the significance of the high-neopterin group as independent determinants of cardiovascular events (hazard ratio, 2.225; 95% CI, 1.283–3.857; P = 0.004). Immunohistochemical staining showed abundant neopterin-positive macrophages in the neointima after BMS implantation but no neopterin-positive macrophages in the neointima after DES implantation.Conclusion: These findings suggest that neopterin is associated with cardiovascular events after coronary stent implantation in patients with SAP. However, there might be a strong association between neopterin and cardiovascular events after BMS but not after DES in these patients.

Prognostic significance and dynamic change of plasma macrophage migration inhibitory factor in patients with acute ST-elevation myocardial infarction

“…In the SA group, patients showed effort-related angina without any change in the clinical pattern in the preceding 2 months. [ 20 ] Finally, patients in the control group only showed discontinuous atypical precordial chest pain, no previous history of heart disease, and represent negative coronary angiography (NCA) results. Additionally, among STEMI group, we randomly chose 39 patients who received PCI within 12 hours after the onset of chest pain were respectively measured circulating MIF levels at different time points to observe dynamic change during hospitalization.…”

Long-Term Clinical Outcomes After Filter Protection During Percutaneous Coronary Intervention in Patients With Attenuated Plaque ― 1-Year Follow up of the VAMPIRE 3 (Vacuum Aspiration Thrombus Reemoval 3) Trial ―

“…In a patient assigned to the CT group, a stent was not deployed because of significant no-reflow phenomena and cardiac arrest requiring cardiopulmonary resuscitation after pre-dilatation. The stent diameter (3.36±0.40 vs. 3.36±0.41, P=0.909) and stent length (23 [18][19][20][21][22][23][24][25][26][27][28][29][30] vs. 24 [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33], P=0.293) were similar in the groups.…”

Neopterin as a biomarker showing risks of developing pathology in bronchi and lungs among workers who have occupational contacts with industrial aerosols

“…Coronary angiography has established that neopterin levels in blood serum depend on how IHD progresses in patients with stable angina pectoris. Research works by many authors confirm that neopterin is a significant component in estimating stability of atheromas in patients with IHD and in monitoring over health of patients after coronary stent implantation [12,13]. Not so many works dwell on examining a role neopterin plays in lung diseases.…”