Indirect evidence for a role of a subpopulation of activated neutrophils in the remodelling process after percutaneous coronary intervention.

AIM: Leukocytes have been implicated in restenosis following percutaneous transluminal coronary angioplasty. We investigated the link between the activated status of circulating neutrophils and restenosis after angioplasty. METHODS AND RESULTS: The population of 108 patients with single, de novo lesions located in native coronary arteries were treated with elective balloon angioplasty (n=44) or stenting (n=64). Pre-, post-procedure and 6-month follow-up, angiograms were analysed by an independent core laboratory. Blood samples were collected immediately before treatment and the antigen CD66, which is specifically expressed by activated neutrophils, was measured. Overall, the average expression of CD66 was 6.4+/-3.6 of mean fluorescence intensity. In the stepwise linear regression model, which included biological, clinical and angiographic variables, absolute gain showed a direct association (P<0.001) with relative late loss (relative late loss=absolute late loss/pre-procedure reference diameter), whereas CD66 expression was inversely associated with relative late loss (P=0.004). CD66 expression also showed an inverse association with relative late loss in the balloon angioplasty treated patients (P=0.002, beta=-0.49). In the stent subgroup, only reference vessel diameter and acute gain were independent predictors of relative late loss. CONCLUSION: Our results confirm the beneficial role of activated neutrophils pre-procedure in the restenotic process after balloon angioplasty. The lack of a relationship between CD66 expression by neutrophils and relative late loss after stenting suggests that this leukocyte may be involved in the remodelling process.

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