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European Heart Journal Advance Access published online on February 27, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn060
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Vascular endothelial growth factor protein levels and gene expression in peripheral monocytes after stenting: a randomized comparative study of sirolimus: eluting and bare metal stents

George E. Kochiadakis1, Maria E. Marketou1, Dimitris Panutsopulos2, Dimitris A Arfanakis1, Emmanuel I. Skalidis1, Nikolaos E. Igoumenidis1, Michael I. Hamilos1, George Sourvinos2, Gregory Chlouverakis3, Demetrios Spandidos2 and Panos E. Vardas1,*

1 Cardiology Department, Heraklion University Hospital, PO Box 1352, Heraklion 71110, Crete, Greece
2 Laboratory of Virology, University of Crete, Crete, Greece
3 Division of Biostatistics, University of Crete, Crete, Greece

Received 6 October 2007; revised 16 January 2008; accepted 24 January 2008.

* Corresponding author. Tel: +30 2810 392877. Email: cardio{at}med.uoc.gr

Aims: Although previous studies have indicated that vascular endothelial growth factor (VEGF) plays an important role in the vascular-healing process after stent implantation, its effect on in-stent restenosis is unclear. We assessed VEGF serum protein levels and gene expression in peripheral monocytes in relation to in-stent restenosis after implantation of sirolimus-eluting (SES) and bare metal stents (BMS) in a non-blinded, randomized study.

Methods and results: Forty-two patients (28 men, age 62 ± 11 years) with stable angina, who underwent elective single-vessel percutaneous coronary intervention, were randomized to SES (n = 21) or BMS (n = 21) implantation. VEGF protein levels in the BMS group showed an increasing trend (P = 0.083), whereas in the SES group they decreased significantly (P = 0.002). BMS induced up-regulation of VEGF mRNA levels, whereas for SES down-regulation was observed. There was no correlation between serum levels and late luminal loss. A significant correlation was found between VEGF gene expression and late luminal loss in both groups (BMS: r = 0.98, P < 0.001; SES: r = 0.65, P = 0.002).

Conclusion: SES, in comparison with BMS, results in lower VEGF protein levels and gene expression in peripheral monocytes. The latter shows a positive relationship with in-stent late-luminal loss, suggesting an essential role in the reduced in-stent restenosis seen in SES.

Key Words: Vascular endothelial growth factor • Sirolimus-eluting stents • Restenosis


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F. S. Czepluch and J. Waltenberger
Vascular endothelial growth factor protein levels and gene expression in peripheral monocytes after stenting: a randomized comparative study of sirolimus-eluting and bare-metal stents
Eur. Heart J., August 1, 2008; 29(15): 1924 - 1925.
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