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Circulating monocytes and in-stent neointima after coronary stent implantation

Daiju Fukuda, MD^*,*, Kenei Shimada, MD^*, Atsushi Tanaka, MD, Takahiko Kawarabayashi, MD, Minoru Yoshiyama, MD^* and Junichi Yoshikawa, MD, FACC^*

^* Department of Internal Medicine and Cardiology, Graduate School of Medicine, Osaka City University Medical School, Osaka, Japan
Division of Cardiology, Baba Memorial Hospital, Sakai, Japan

View larger version (28K): [in a new window]   Figure 1 Serial changes in each white blood cell (WBC) fraction count after stent implantation were demonstrated. Monocytes increased after stent implantation and reached a peak level two days after the procedure (from 350 ± 167 to 515 ± 149/mm3, p < 0.01). Other fractions had no significant serial change.

View larger version (21K): [in a new window]   Figure 2 Comparison of maximum monocyte counts. Patients with restenosis showed a significantly larger maximum monocyte count than did patients without restenosis (642 ± 110 vs. 529 ± 77/mm3, p < 0.001).

View larger version (28K): [in a new window]   Figure 3 Serial changes in each white blood cell (WBC) fraction count in the non-intervention group were demonstrated. Unlike patients who underwent stent implantation, there were no significant serial changes in each WBC fraction count, including monocytes, in the non-intervention group.

View larger version (34K): [in a new window]   Figure 4 The relationship between the maximum count of each white blood cell (WBC) fraction and in-stent neointimal volume after six-month follow-up was demonstrated. The maximum monocyte count showed a significant positive correlation with in-stent neointimal volume (r = 0.44, p < 0.0001). Other fractions had no significant correlation with in-stent neointimal volume.

View larger version (77K): [in a new window]   Figure 5 Typical examples of patients with restenosis (A) and without restenosis (B). Both of these patients underwent stent implantation in the mid right coronary artery portion using a 3.5-mm Multi-Link stent (15 mm in length) (arrows). The patient with restenosis presented with 76.12 mm3 of in-stent neointima and 621/mm3 maximum monocyte count, whereas the patient without restenosis had 27.9 mm3 of in-stent neointima and 259/mm3 maximum monocyte count.