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 tr ansluminal coronary angioplasty. We investigated the link between the activ ated status of circulating neutrophils and restenosis after angioplasty. Methods and Results The population of 108 patients with single, de novo les ions located in native coronary arteries were treated with elective balloon angioplasty (n=44) or stenting (n=64). Pre-, post-procedure and 6-month fo llowup, angiograms were analysed by an independent core laboratory. Blood s amples were collected immediately before treatment and the antigen CD66, wh ich is specifically expressed by activated neutrophils, was measured. Overa ll, the average expression of CD66 was 6.4 +/- 3.6 of mean fluorescence int ensity. In the stepwise linear regression model, which included biological, clinical and angiographic variables, absolute gain showed a direct associa tion (P<0.001) with relative late loss (relative late loss = absolute late loss <divided by> pre-procedure reference diameter), whereas CD66 expressio n was inversely associated with relative late loss (P=0.004). CD66 expressi on also showed an inverse association with relative late loss in the balloo n angioplasty treated patients (P=0.002, beta= -0.49). In the stent subgrou p, only reference vessel diameter and acute gain were independent predictor s of relative late loss. Conclusion Our results confirm the beneficial role of activated neutrophils pre-procedure in the restenotic process after balloon angioplasty. The lac k of a relationship between CD66 expression by neutrophils and relative lat e loss after stenting suggests that this leukocyte may be involved in the r emodelling process. (Eur Heart J 2001; 22: 580-586). (C) 2001 The European Society of Cardiology.