BACKGROUND: Direct stenting might be less traumatic than conventional predilation stent implantation, as it simultaneously treats the lesion and seals possible artery dissection. Potentially, this could reduce the deleterious impact on the systemic inflammatory response. OBJECTIVES: To compare the effects of direct and conventional stenting techniques on systemic inflammatory response. METHOD: Patients referred for elective implant of coronary stenting were divided into 2 groups: direct stenting and conventional stenting. Systemic inflammatory response from all patients was evaluated through pre and post-stenting serum levels range of high-sensitivity C-reactive protein (hs-CRP) and CD40L. RESULTS: 34 patients were included in the Direct Stenting Group, while 26 patients were treated with predilation. Demographic and angiographic data were similar between Direct and Conventional groups, respectively: age 58.0±11.6 and 59.5±9.8 (p=0.60); male 67.6% and 69.2% (p=0.99); diabetics 17.7% and 26.9% (p=0.53); B2 or C ACC/AHA lesion type 52.9% and 38.5% (p=0.31); pre-procedure reference vessel diameter (mm) 2.67±0.7, and 2.81±0.7 (p=0.45). Post-intervention in both groups showed similar increase in hsCRP serum levels (p time<0.001; p interaction=0.86; p group=0.22) and a similar decrease in CD40L serum levels (p time=0.02; p interaction=0.81; p group=0.39). CONCLUSION: Direct and conventional stenting techniques were equivalent regarding their effects on the systemic inflammatory response.
Angioplasty, transluminal, percutaneous coronary; C-reactive protein; CD40 ligand
