Renal angioplasty causes a rapid transient increase in inflammatory biornarkers, but reduced levels of interleukin-6 and endothelin-1 1 month after intervention

被引:18
作者
Alhadad, Alaa [1 ]
Guronb, Gregor
Fortuna-Nowakowska, Ella
Saeedb, Aso
Mattiasson, Ingrid
Jensen, Gert
Lindblad, Bengt
Iter, Anders Gotts
Herlitz, Hans
机构
[1] Lund Univ, Malmo Univ Hosp, Dept Vasc Dis, S-20502 Malmo, Sweden
[2] Sahlgrens Univ Hosp, Dept Nephrol, S-41345 Gothenburg, Sweden
关键词
cD40; ligand; C-reactive protein; endothelin-1; inflammation; interleukin-6; neopterin; percutaneous transluminal renal angioplasty; renal artery stenosis; renovascular hypertension; tumor necrosis factor-alpha;
D O I
10.1097/HJH.0b013e328244e2ca
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
Objective To examine prospectively whether inflammatory biomarkers and endothelin (ET)-1 are increased in patients with renal artery stenosis (RAS), and to investigate how treatment with percutaneous transluminal renal angioplasty (PTRA) affects these variables during the first month after intervention. Methods One hundred patients with suspected RAS undergoing renal angiography were included. PTRA was performed if the trans-stenotic mean arterial pressure gradient was >= 10 mmHg. High-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF alpha), neopterin, CD40 ligand (CD40L) and endothelin-1 (ET-1) were measured before, and 1 day and 1 month after PTRA (n = 61) or diagnostic angiography only (n = 39). Results At baseline there were no significant differences in inflammatory biomarkers or ET-1 levels between patients subsequently undergoing PTRA or angiography only. After angiography, IL-6 and hs-CRP had increased in both groups compared to baseline (P< 0.001). At this time point hs-CRP (10.90 +/- 1.48 versus 6.37 +/- 1.61 mg/l; P<0.05) and IL-6 (13.70 +/- 0.94 versus 13.00 +/- 0.17 pg/ml; P<0.01) were higher in the PTRA group than in patients subjected to angiography only. One month after PTRA, systolic blood pressure and levels of IL-6 and ET-1 were lower than before intervention (P<0.05), whereas CD40L had increased compared to baseline (P<0.01). Conclusion In patients with RAS, PTRA triggers rapid transient increases in hs-CRP and IL-6; however, 1 month after PTRA, both IL-6 and ET-1 had decreased compared to before intervention, indicating beneficial effects of PTRA on inflammation and the endothelin system.
引用
收藏
页码:1907 / 1914
页数:8
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