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Effects of Percutaneous Coronary Intervention on Peripheral Venous Blood Circulating Endothelial Cells and Plasma Indices of Endothelial Damage/Dysfunction^*

^* From the Haemostasis, Thrombosis and Vascular Biology Unit (Drs. Boos, Balakrishnan, Jessani, Blann, and Lip), University Department of Medicine, City Hospital, Birmingham, UK.

Correspondence to: Gregory Y. H. Lip, MD, Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK; g.y.h.lip{at}bham.ac.uk

Abstract

Background: The relationship between endothelial damage/dysfunction and coronary artery disease is well recognized. However, the effects of percutaneous coronary intervention (PCI) [stenting/angioplasty] on circulating markers of endothelial damage/dysfunction (eg, von Willebrand factor [vWF], soluble E-selectin [sEsel] levels, and more recently circulating endothelial cells [CECs]) has been less well defined.

Aims and methods: We investigated the effects of both diagnostic coronary angiography (CA) [n = 15; blood sampling immediately before CA and 15 min after CA] and PCI (n = 38; blood sampling before PCI, 15 min after PCI, and 24 h after PCI) on levels of CECs, vWF, and sEsel across comparable patient groups. We also included a cohort of comparable healthy control subjects in order to compare baseline levels of three endothelial markers.

Results: There were no differences in baseline levels of CECs, vWF, or sEsel between the three study groups (healthy control subjects, CA, PCI; all p = not significant). Following CA (before to 15 min after), there were no significant changes in vWF and CECs (p = not significant). Following PCI, there were significant increases observed at 15 min after PCI and at 24 h after PCI (when compared with pre-PCI levels) in CECs (p = 0.0006), vWF (p = 0.007), and sEsel (p = 0.024).

Conclusion: We observed significant increases in three endothelial markers (CECs, vWF, and sEsel) with elective PCI but not CA. This is in keeping with endothelial damage/dysfunction following PCI.

Key Words: angioplasty • circulating endothelial cells • coronary • endothelial • soluble E selectin • stenting • von Willebrand factor