Dexamethasone-eluting stents and plasma concentrations of adhesion molecules in patients with unstable coronary syndromes: results of the historically controlled SESAME study.Clin Ther. 2005 Sep; 27(9):1411-9.CT
Plasma concentrations of intercellular adhesion molecule-1 [ICAM-1], vascular cell adhesion molecule-1 [VCAM-1], and E-selectin may increase after percutaneous coronary intervention (PCI).
The aim of this study was to assess whether anti-inflammatory treatment with steroid-eluting stents influenced concentrations of adhesion molecules after PCI in patients with unstable coronary syndromes.
Consecutive patients with unstable coronary syndromes who were prospectively assigned to undergo implantation of a dexamethasone-eluting stent were compared with a control group of consecutive historical patients who received a similar non-drugeluting stent in the period immediately preceding availability of the steroid-eluting stents. Circulating concentrations of adhesion molecules were measured before the procedure and at 6 and 24 hours after implantation.
The study included 50 patients who received the dexamethasone-eluting stent (41 men, 9 women; mean [SD] age, 60  years) and 50 historical controls who received the non-drug-eluting stent (40 men, 10 women; mean age, 63  years). Baseline values for the adhesion molecules were similar in the 2 groups: in patients who received the dexamethasone-eluting stent, mean (SD) values were 210 (41) ng/mL for ICAM-1, 637 (119) ng/mL for VCAM-1, and 46 (9) ng/mL for E-selectin; in the control group, the corresponding values were 218 (42), 618 (140), and 43 (10) ng/mL. Circulating concentrations at 24 hours were significantly lower in patients receiving the drug-eluting stent compared with controls for both ICAM-1 (279  vs 338  ng/mL, respectively; P = 0.001) and VCAM-1 (772  vs 896  ng/mL; P = 0.004). There was no significant between-group difference in E-selectin concentrations at 24 hours (60  vs 56  ng/mL).
In this study, dexamethasone-eluting stents reduced plasma concentrations of ICAM-1 and VCAM-1 after PCI in patients with unstable coronary syndromes compared with historical controls.