The Basic And Clinic Research Of Resrtenosis After PCI

Along with the fast development of equipment,technology,strategy and auxiliary treatment,the indications of percutaneous coronary intervention(PCI) in clinical and anatomical is getting more and more broad,updated equipment and the anti-thrombus treatment enhanced its success ratio to 98%, the operation related mortality rate reduced to about 1%,needed the emergency CABG rate<0.5%.PCI is getting more and more pivotal in the revascularization treatment of coronary artery disease.Today,more than 150 million patients undergoing coronary intervention each year,but restenosis limits its long-term efficacy.Although many DES have be used as a viable treatment to prevent intimal hyperplasia,the problem has not been overcomed yet.Until now,there are still about 10% patients undergoing PCI requiring revascularization treatment.Resolution of this issue will greatly enhance the long-term efficacy of PCI,improve the patients'quality of life and save a lot of resources and funds.Studies showed that neointima after vascular injury is mainly composed of the hyperplastic smooth muscle cell and the excessive extracellular matrix. bone marrow and other tissuesmultipotential differentiation ability can differentiate into smooth muscle cells to participate the process of cardiovascular disease.The cells can differentiate into smooth muscle cells are called smooth muscle progenitor cells.Its surface markers is considered as CD14 and CD105.We investigate the number changes of peripheral SPCs in CHD patients as well asthe number of peripheral SPCs in order to clarify the relationship of peripheral SPCs'number with restenosis.Changes of circulating smooth muscle progenitor cells in patients with coronary heart disease before and after percutaneous coronary intervention.AIM:To compare the number of circulating smooth muscle progenitor cells (SPCs) between normal controls and patients with coronary heart diseases (CHD) and to explore the influence of percutaneous coronary(PCI) on the SPCs number in CHD patients.METHODS: A total of 33 hospitalized male CHD patients were enrolled and divided into three groups, including stable angina pectoris (SAP) group and unstable angina pectoris (UA) group.Patients with normal coronary angiography served as controls.The percentage of SPCs in peripheral blood nucleated cells was measured at admission and immediately and 72 hours after PCI in CHD patients by double-color flow cytometry analysis.SPCs were identified with CD14+/CD105+.RESULTS:At admission,the percentage of SPCs in peripheral blood nucleated cells was significantly higher in SAP group(0.20±0.13)% and UA group(0.28±0.18)% than that in the control group[(0.12±0.10)%,all P<0.01], and the number of SPCsin UA group was significantly higher than that in the SAP group (P<0.01).In the UA group, the number of SPCs at 72 hours after PC(I0.34±0.25)% was significantly higher than that before operation(0.28±0.18)% (P<0.01) and tended to be higher than the value immediately after PCI.CONCLUSION:Stent implantation may induce the mobilization of bone marrow-derived smooth muscle progenitor cells.The number of peripheral SPCs in CHD patients is lower than that in normal subjects and is negatively related with the severity of coronary heart disease.The number of circulating SPCs increases post PCI in patients with unstable angina pectoris.