| In-stent restenosis: contributions of inflammatory responses and arterial injury to neointimal hyperplasia. | |
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MedLine Citation:
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PMID: 9426044 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: We examined the relative contributions of inflammation and arterial injury to neointimal formation in a porcine coronary overstretch restenosis model. BACKGROUND: Previous studies established that stents cause neointimal proliferation proportional to injury. Although inflammation has been postulated to be a major contributor to restenosis after angioplasty, there is a paucity of data on the relation between inflammation and subsequent neointimal formation. METHODS: Twenty-one pigs underwent balloon injury followed by implantation of oversized, tubular, slotted stents (stent/artery ratio 1.2:1) in the left anterior descending coronary artery. Morphometric analysis of the extent of injury (graded as injury score 0 to 3) and inflammation (graded as inflammation score 0 to 3) 1 month later was assessed and correlated with neointimal formation. RESULTS: An inflammatory reaction was observed in 20 of 21 pigs, and significant positive correlations were found between the degree of arterial injury and the extent of the inflammatory reaction (r = 0.80, p < 0.01) and between the extent of inflammatory reaction and the neointimal thickness (r = 0.75, p < 0.01), neointimal area (r = 0.53, p = 0.01) and percent area stenosis (r = 0.66, p < 0.01) within the stents. Importantly, there were areas with inflammation only in the absence of injury, and vice versa, that were also associated with neointimal hyperplasia. CONCLUSIONS: These data suggest that the inflammatory reaction plays an equally important role as arterial injury in neointimal formation after coronary stenting, and that anti-inflammatory approaches may be of value to reduce in-stent restenosis. |
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Authors:
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R Kornowski; M K Hong; F O Tio; O Bramwell; H Wu; M B Leon |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 31 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1998 Jan |
Date Detail:
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Created Date: 1998-01-27 Completed Date: 1998-01-27 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 224-30 Citation Subset: AIM; IM |
Affiliation:
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Department of Internal Medicine (Cardiology Division) and Medlantic Research Institute of the Washington Hospital Center, DC, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Cell Division Constriction, Pathologic Coronary Vessels / immunology, pathology* Disease Models, Animal Hyperplasia Inflammation / pathology Stents* Swine Tunica Intima / immunology, pathology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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