Low basal levels of circulating adiponectin in patients undergoing coronary stenting predict in-stent restenosis, independently of basal levels of inflammatory markers: Lipoprotein associated phospholipase A2, and myeloperoxidase

Objective: The aim of this study was to find a pre-interventional marker with the capacity to Predict in-stent restenosis (ISR). Considering the anti-atherosclerotic role of adiponectin (APO). an adipocytokine with anti-inflammatory, anti-proliferative, anti-oxidative and anti-thrombotic properties. low plasma levels of APO might be correlated with the risk of ISR. We investigated the correlations between the plasma levels of APO and two markers of inflammation: lipoprotein associated phospholipase A2 (Lp-PLA2) and myeloperoxidase (MPO). Design and methods: 80 patients with angiographically significant stenosis underwent percutaneous coronary intervention (PCI)with bare metal stent. Plasma APO concentration and plasma Lp-PLA2 and MPO activities Were evaluated immediately before and after PCI. then followed up at 24, 48, 72 h and at 1, 3, 6 months respectively. ISR was evaluated at 6 months after stenting by follow-up coronary angiograms, and it was defined as > 50% stenosis of the target lesion. Results: ISR was Present in 31.75% of patients. Baseline APO plasma concentration. measured before PCI. was lower in ISR Patients than those without ISR [3.97 (+/- 1.05) vs 6.65 (+/- 2.95) mu g/mL respectively, p<0.001]. The Patients with APO values less than 4.9 mu g/mL at discharge were more susceptible to develop ISR (odd ratio. 4.27; 95% CI, 1.56-11.72,p<0.001). ISR rate was independent of inflammation markers Lp-PLA2 and MPO baseline values measured before PCI. Conclusions: The persistence of a low APO plasma level at discharge and 6 months afterwards may be used as a clinically useful marker for ISR prediction in patients undergoing PCI. (c) 2008 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.