18 research outputs found
Intracoronary gamma-radiation therapy after angioplasty inhibits recurrence in patients with in-stent restenosis
BACKGROUND: Treatment of in-stent restenosis presents a critical
limitation of intracoronary stent implantation. Ionizing radiation has
been shown to decrease neointimal formation within stents in animal models
and in initial clinical trials. We studied the effects of intracoronary
gamma-radiation therapy versus placebo on the clinical and angiographic
outcomes of patients with in-stent restenosis. METHODS AND RESULTS: One
hundred thirty patients with in-stent restenosis underwent successful
coronary intervention and were then blindly randomized to receive either
intracoronary gamma-radiation with (192)Ir (15 Gy) or placebo. Four
independent core laboratories blinded to the treatment protocol analyzed
the angiographic and intravascular ultrasound end points of restenosis.
Procedural success and in-hospital and 30-day complications were similar
among the groups. At 6 months, patients assigned to radiation therapy
required less target lesion revascularization and target vessel
revascularization (9 [13.8%] and 17 [26.2%], respectively) compared with
patients assigned to placebo (41 [63.1%, P=0.0001] and 44 [67.7%,
P=0.0001], respectively). Binary angiographic restenosis was lower in the
irradiated group (19% versus 58% for placebo, P=0.001). Freedom from major
cardiac events was lower in the radiation group (29.2% versus 67.7% for
placebo, P<0.001). CONCLUSIONS: Intracoronary gamma-radiation used as
adjunct therapy for patients with in-stent restenosis significantly
reduces both angiographic and clinical restenosis
RANTES/CCL5 and Risk for Coronary Events: Results from the MONICA/KORA Augsburg Case-Cohort, Athero-Express and CARDIoGRAM Studies
BACKGROUND: The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted)/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events.
METHODS AND FINDINGS: We conducted a case-cohort study within the population-based MONICA/KORA Augsburg studies. Baseline RANTES serum levels were measured in 363 individuals with incident coronary events and 1,908 non-cases (mean follow-up: 10.2±4.8 years). Cox proportional hazard models adjusting for age, sex, body mass index, metabolic factors and lifestyle factors revealed no significant association between RANTES and incident coronary events (HR [95% CI] for increasing RANTES tertiles 1.0, 1.03 [0.75-1.42] and 1.11 [0.81-1.54]). None of six CCL5 single nucleotide polymorphisms and no common haplotype showed significant associations with coronary events. Also in the CARDIoGRAM study (>22,000 cases, >60,000 controls), none of these CCL5 SNPs was significantly associated with coronary artery disease. In the prospective Athero-Express biobank study, RANTES plaque levels were measured in 606 atherosclerotic lesions from patients who underwent carotid endarterectomy. RANTES content in atherosclerotic plaques was positively associated with macrophage infiltration and inversely associated with plaque calcification. However, there was no significant association between RANTES content in plaques and risk for coronary events (mean follow-up 2.8±0.8 years).
CONCLUSIONS: High RANTES plaque levels were associated with an unstable plaque phenotype. However, the absence of associations between (i) RANTES serum levels, (ii) CCL5 genotypes and (iii) RANTES content in carotid plaques and either coronary artery disease or incident coronary events in our cohorts suggests that RANTES may not be a novel coronary risk biomarker. However, the potential relevance of RANTES levels in platelet-poor plasma needs to be investigated in further studies
RANTES/CCL5 and risk for coronary events: Results from the MONICA/KORA Augsburg case-cohort, Athero-express and CARDIoGRAM studies
Background: The chemokine RANTES (regulated on activation, normal T-cell expressed and secreted)/CCL5 is involved in the pathogenesis of cardiovascular disease in mice, whereas less is known in humans. We hypothesised that its relevance for atherosclerosis should be reflected by associations between CCL5 gene variants, RANTES serum concentrations and protein levels in atherosclerotic plaques and risk for coronary events. Methods and Findings: We conducted a case-cohort study within the population-based MONICA/KORA Augsburg studies. Baseline RANTES serum levels were measured in 363 individuals with incident coronary events and 1,908 non-cases (mean follow-up: 10.2±