Elevated high sensitive C-reactive protein and apelin levels after percutaneous coronary intervention and drug-eluting stent implantation.

OBJECTIVE: Percutaneous coronary intervention (PCI) triggers an acute inflammatory response, while sirolimus is known to have anti-inflammatory properties; the inflammatory system response to PCI after sirolimus-eluting stent placement remains unclear. The purpose of this study is to determine the changes in high sensitive C-reactive protein (hs-CRP) and apelin after PCI procedure and drug-eluting stent implantation in patients with and without reduced left ventricular systolic function.
METHODS: Forty-eight consecutive patients undergoing PCI at the Beijing Anzhen Hospital between July and September 2006 were recruited. Sirolimus-eluting stents were employed in all patients. Blood samples were drawn immediately before and 24 h after the procedure. Plasma hs-CRP and apelin levels were determined by enzyme immunoassay.
RESULTS: Paired t-test revealed a significant increase in both hs-CRP and apelin post-procedure (P=0.006 and P<0.0001, respectively). Patients with reduced left ventricular ejection fraction (LVEF) had significantly lower baseline apelin levels compared to those with normal ventricular function [(46.8+/-10.8) vs. (72.0+/-8.4) pg/ml, P<0.001]. However, apelin increased to a level similar to the level of those with normal left ventricular systolic function 24 h after the PCI procedure [(86.7+/-11.6) vs. (85.1+/-6.1) pg/ml, P=0.72].
CONCLUSIONS: hs-CRP and apelin levels increased after PCI and sirolimus-eluting stent implantation. Patients with impaired left ventricular systolic function had significantly lower baseline apelin levels, which increased significantly after PCI.