Association Between Circulating Monocyte Subsets and In-Stent Restenosis After Coronary Stent Implantation in Patients With ST-Elevation Myocardial Infarction

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Background: Recent studies have shown that monocytes in human peripheral blood are heterogeneous. The clinical significance of 2 distinct monocyte subsets as a marker of late in-stent restenosis (ISR) following implantation of bare-metal stents (BMSs) in patients with acute myocardial infarction (AMI) was examined. Methods and Results: Seventy-one consecutive patients with AMI who underwent BMS implantation were enrolled in the study. Peripheral blood was collected 12 days after AMI onset. Two distinct monocyte subsets (CD14+CD16-CCR2+ and CD14+CD16+CX3CR1+) were measured by flow cytometry. All patients underwent angiography at a scheduled follow up after 9 months. CD14+CD16+CX3CR1+ monocyte subset counts were significantly higher in patients with restenosis than in patients without restenosis, whereas neither the total monocytes nor the CD14+CD16-CCR2+ subset counts differed significantly between the 2 groups of patients. There was also a significant positive correlation between the CD14+CD16+CX3CR1+ monocyte counts and angiographic late lumen loss. In multivariate analysis, the CD14+CD16+CX3CR1+ monocyte count was an independent predictor for in-stent late lumen loss. Conclusions: CD14+CD16+CX3CR1+ monocytes might have a role in ISR following coronary BMS implantation in patients with AMI.