ABC | Volume 111, Nº2, August 2018

Original Article Farsky et al Persistent inflammation after stent Arq Bras Cardiol. 2018; 111(2):134-141 Figure 1 – Expression of inflammatory genes in peripheral blood. The expression of the genes CD40 (a), IL-6 (b), INFG (c), LIGHT (d), NFKB (e), TNF (f), ICAM (g) and VCAM (h) was evaluated by real-time PCR using GAPDH gene as internal control to calculate relative expression (2- ΔΔCT ). The patients with coronary stent implantation (n = 35) were compared with controls (n = 25) using nonparametric Mann-Whitney U test. The difference is considered significant for p-values < 0.05. 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 a) CD40 e) NFKB f) TNF g) ICAM b) IL6 c) IFNG p = 0.01 p = 0.07 p = 0.03 p = 0.88 Relative Expression Relative Expression Relative Expression Relative Expression Relative Expression Relative Expression Stent Control Stent Control Stent Stent Stent Control Stent Control 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 NF g) ICAM h) VCAM L6 c) IFNG d) LIGHT p = 0.03 p = 0.35 p = 0.65 p = 0.88 p = 0.52 p = 0.05 Relative Expression Relative Expression Relative Expression Relative Expression Stent Control Stent Control Stent Control Stent Control Stent Control Stent Control 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 a) CD40 e) NFKB f) TNF g) ICAM b) IL6 c) IFNG p = 0.01 p = 0.07 p = 0.03 p = 0.88 Relative Expression Relative Expression Relative Expression Relative Expression Relative Expression Relative Expression Stent Control Stent Control Stent Stent Stent Control Stent Control 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 100 10 1 0.1 0.01 NF g) ICAM h) VCAM L6 c) IFNG d) LIGHT p = 0.03 p = 0.35 p = 0.65 p = 0.88 p = 0.52 p = 0.05 Relative Expression Relative Expression Relative Expression Relative Expression Stent Control Stent Control Stent Control Stent Control Stent Control Stent Control from PCI, and 32 patients (78%) had it more than one year before. A former study showed that the inflammatory reaction inherent to PCI no longer exists in this period. 12 No patient with drug-eluted stent (DES) was enrolled in the present study. On the basis of previous literature, a higher number of T lymphocytes and macrophages is observed in DES lesions than in BMS lesions, suggesting the mechanism of restenosis after DES implantation may be different from that observed after BMS implantation. 13 In this study, the gene expression in peripheral blood cells and the protein localization in coronary artery tissues were carried out to evaluate systemic and local inflammation, respectively. It is worth mentioning that CABG surgery represents a rare opportunity to obtain coronary tissue samples for research without harm to patients, that is why few previous studies worked with this kind of biological sample. In most of them, samples were obtained from the atherosclerotic plaque by endarterectomy. 14,15 137