Coronary aspirate TNFalpha reflects saphenous vein bypass graft restenosis risk in diabetic patients

Background: Patients with diabetes mellitus (DM) have an increased risk for periprocedural complications and adverse cardiac events after percutaneous coronary intervention. We addressed the potential for coronary microvascular obstruction and restenosis in patients with and without DM undergoing stenting for saphenous vein bypass graft (SVG) stenosis under protection with a distal occlusion/aspiration device. Methods: SVG plaque volume and composition were analyzed using intravascular ultrasound before stent implantation. Percent diameter stenosis was determined from quantitative coronary angiography before, immediately after and 6 months after stent implantation. Coronary aspirate was retrieved during stent implantation and divided into particulate debris and plasma. Total calcium, several vasoconstrictors, and tumor necrosis factor (TNF)alpha in particulate debris and coronary aspirate plasma were determined. Results: Patients with and without DM had similar plaque volume, but larger necrotic core and greater particulate debris release in patients with than without DM (20.3+/-2.7 vs. 12.7+/-2.6% and 143.9+/-19.3 vs. 75.1+/-10.4 mg, P
Source: Cardiovascular Diabetology - Category: Cardiology Authors: Source Type: research