Effect Of Amlodipine On In-stent Restenosis After Percutaneous Transluminal Coronary Intervention And Research Of Its Correlations With Adiponectin

Objective:Study on effect of Amlodipine on in-stent restenosis after percutaneoustransluminal coronary intervention, and research of the serum adiponctin level and itscorrelation with markers of inflammation and endothelial function.Methods:A total of fifty-five coronary heart disease patients form March2011to October2011with successful percutaneous transluminal coronary intervention. Patients weredivided randomly into the control group:(routine treatment group, n=25), Amlopinegroup(treatment group, n=30). Serum APN（Adiponectin）, high sensitivity C-reactiveprotein (hs-CPR), Fibrinogen (Fbg), Endothelin-1and oxidation nitrogen (NO) weredetected in patients with the angiograms of post-intervention and6months aftertreatment for two group, and analysis their mutal correlation. Observation the resultsof coronary arteriography (CAG) and the main adverse cardiac events after PCI,evaluation the protection effect of Amlodipine on in-stent restenosis. Results:①Comparison of pre-operation blood lipid (TC,TG, HDL-c, LDL-c), APN, Fbg,hs-CRP, ET-1, NO and basic clinical information (age distribution, men/womenration, smoking history, diabetes, hypertension, hyperlipemia, stability angina,unstable angina and acute myocardial infarction) showed no statistical significance(P>0.05).②Comparison of blood lipid levels in two group after operating: after6months, blood lipid(TC, TG, LDL-c) was decreased significantly in Amlodipinegroup compared to control group (P＜0.01). HDL-c level of amlodipine group washigher than control group, it showed statistically difference (P＜0.05).④Amlodipine group compared with control group, after6months blood APN levelswas increased, showed significant difference(P＜0.01).⑤Comparison two grouppatients, after6months the level of hs-CRP was significantly lower in Amlodipinegroup, and showed significant difference(P＜0.01).⑥Comparison of endothelialcell function in patients after6months: ET-1level of Amlodipine group wassignificantly lower than the control group, and NO level higher than the controlgroup, with significantly statistical difference (P＜0.01).⑦The levels of Fbg after6months in Amlodipine group compared with control group, it showed difference(P＜0.01).⑧Pearson analysis of correlation of level of serum APN and indicatiors:the blood lipid(TC, TG and LDL-c) in two groups and serum APN have negativecorrelation, and HDL-c correlated with APN. Blood hs-CRP, ET-1have negativecorrelation with APN, while APN level was significantly correlated withNO.⑨Recurrence angina events were6cases in the control group and have3casesrestenosis; Among the Amlodipine group there were3cases of angina events, and2case srestenosis，it showed no statistical significance (P>0.05).While combinedcardiovascular adverse events incidence of the amlodipine group were less thancontrol group(P=0.026). Multiple step regression analysis showed that HDL-c, LDL-cand NO were independently correlated with the level of adiponectin. Conclusion1. After percutaneous transluminal coronary intervention in patients the serumAdiponectin level has correlation with inflammatory factor and endothelial functionfactor, may play a important role in the ISR.2. The incidence of adverse cardiac events were reduction after intervention withamlodipine, it may be related to the adiponectin level rise and the changes ofendothelial function and inflammatory factor.