C 2009, the Authors Journal compilation C 2009, Wiley Periodicals, Inc. DOI: 10.1111/j.1540-8183.2009.00429.x Comparison of the Systemic Levels of Inflammatory Markers after Percutaneous Coronary Intervention with Bare Metal versus Sirolimus-Eluting Stents ABDALLAH G. REBEIZ, M.D., F.A.C.C., ELIE ZOGHBI, M.D., RAMI HARB, M.D., SONIA YOUHANNA, B.SC., HADI N. SKOURI, M.D., ADEL DIMASSI, M.D., GILBERT ABOU-NADER, M.D., ANTOINE NASRALLAH, M.D., F.A.C.C., JABER SAWAYA, M.D., F.A.C.C., WALID GHARZUDDINE, M.D., and SAMIR ALAM, M.D., F.A.C.C. From the American University of Beirut Medical Center, Division of Cardiology, Beirut, Lebanon Background: Percutaneous coronary intervention (PCI) with bare metal stent (BMS) deployment causes plaque disruption and a rise in systemic levels of C-reactive protein (CRP), interleukin (IL)-6, and monocyte chemoat- tractant protein (MCP)-1. Our aim is to study whether PCI with sirolimus-eluting stent (SES) use attenuates this response. Methods: Patients with stable angina undergoing single-vessel PCI were enrolled in a randomized, open-label fashion into a BMS group or an SES group. Blood samples were drawn pre-PCI, 24 hours post-PCI, and 30 days post-PCI. Systemic concentrations of CRP, IL-6, and MCP-1 were measured at all time points. Results: In total, 41 patients were enrolled (21 in the BMS group and 20 in the SES group). The baseline plasma concentrations of all markers were comparable between groups. At 24 hours, the mean plasma CRP concentration in the SES group was 20.21 mg/dL versus 8.95 mg/dL in the BMS group (P = 0.15). The mean plasma IL-6 concentration at 24 hours was 25.41 pg/mL in the SES group versus 17.44 pg/mL in the BMS group (P = 0.17). The mean plasma MCP-1 concentration at 24 hours was 382.38 pg/mL in the SES group versus 329.04 pg/mL in the BMS group (P = 0.2). At 30 days, plasma concentrations of all three markers decreased to similar values between groups. Conclusions: The use of SES did not inhibit the rise in systemic concentrations of CRP, IL-6, and MCP-1 at 24 hours or 30 days post-PCI, compared with BMS. Moreover, at 24 hours, there was a trend for higher systemic levels of all proinflammatory markers in the SES group compared with the BMS cohort. (J Interven Cardiol 2009;22;169–174) Introduction Percutaneous coronary intervention (PCI) with stent insertion is currently the leading form of coronary revascularization worldwide. The use of drug-eluting Presented in abstract form at the American College of Cardiology Scientific Sessions, March 2008, Chicago, Illinois. Address for reprints: Abdallah G. Rebeiz, M.D., F.A.C.C., F.S.C.A.I., American University of Beirut Medical Center, P.O. Box 20C, Beirut, Lebanon. Fax: +961-1-370814; e-mail: ar20@aub.edu.lb stents (DES) has been shown in multiple randomized controlled trials to decrease the incidence of in-stent restenosis secondary to neointimal hyperplasia. 1,2 PCI with or without the deployment of a stent involves a me- chanical disruption of an atheromatous plaque, thereby causing direct injury to the vascular wall and endothe- lium, leading to local inflammatory responses charac- terized by the adhesion and infiltration of leucocytes at the site of injury. 3 Mechanical stretch and vascular injury induce the de novo production and release of in- terleukin (IL)-6 in the coronary circulation following PCI, which in turn induces the hepatic production of Vol. 22, No. 2, 2009 Journal of Interventional Cardiology 169