Baseline patient characteristics.

Aim
Inflammation plays a central role in the pathogenesis of atherosclerosis and in the sequelae of percutaneous coronary intervention (PCI). Previous work demonstrated that intermediate monocytes (CD14++CD16+) are associated with adverse cardiovascular events, yet monocyte subset response following elective PCI has not been described. This article explores the changes in monocyte subset and humoral response after elective PCI.
Methods
This prospective study included 30 patients without inflammatory diseases being referred for elective PCI. We included patients treated with drug coated balloons or 2nd generation drug eluting stents. Patients underwent blood tests at baseline (prior to PCI), four hours, two weeks and two months later. Analyses were performed in terms of monocyte subsets (classical CD14++CD16-, intermediate CD14++CD16+ and non-classical CD14+CD16++), gene expression of CD14+ leucocytes and humoral biomarkers.
Results
Intermediate monocytes decreased significantly four hours after PCI, were recovered at two weeks, and increased significantly at two months post elective, uncomplicated PCI. They remain significantly elevated in the DES group but not in the DCB group. Gene expression analysis of CD14+ leucocytes showed IL18 had decreased expression at two weeks, CXCR4 and IL1β decreased at two months, while pentraxin 3 increased at two weeks and two months. In terms of humoral biomarkers, hsTnI remains elevated up to two weeks post PCI while IL6 and TNFα remain elevated till two months post PCI.
Conclusion
Intermediate monocytes increase significantly two months following elective, uncomplicated PCI. They remain significantly elevated in the DES group but not in the DCB group suggesting that the PCI strategy could be one of the ways to modulate the inflammatory response post PCI.

研究目的
炎症在动脉粥样硬化的发病机制以及经皮冠状动脉介入治疗（percutaneous coronary intervention, PCI）术后后遗症中发挥核心作用。既往研究表明，中间型单核细胞（CD14++CD16+）与不良心血管事件相关，但择期PCI术后的单核细胞亚群应答特征尚未见报道。本研究旨在探讨择期PCI术后单核细胞亚群及体液应答的变化情况。

研究方法
本前瞻性研究纳入30例无炎症性疾病、拟行择期PCI的患者，所有患者均接受药物涂层球囊或第二代药物洗脱支架治疗。患者分别于基线（PCI术前）、术后4小时、2周及2个月时接受血液检测。分析内容涵盖单核细胞亚群（经典型CD14++CD16-、中间型CD14++CD16+及非经典型CD14+CD16++）、CD14+白细胞的基因表达水平以及体液生物标志物水平。

研究结果
中间型单核细胞在PCI术后4小时显著降低，于术后2周恢复至基线水平，并在无并发症择期PCI术后2个月时显著升高。该类细胞在药物洗脱支架（drug eluting stents, DES）组中仍维持显著升高状态，但在药物涂层球囊（drug coated balloons, DCB）组中未出现该变化。对CD14+白细胞的基因表达分析显示，IL18在术后2周表达下调，CXCR4与IL1β在术后2个月表达下调，而五聚蛋白3（pentraxin 3）在术后2周及2个月时表达上调。体液生物标志物方面，高敏肌钙蛋白I（high-sensitivity troponin I, hsTnI）在PCI术后2周内仍维持升高状态，而IL6与肿瘤坏死因子α（tumor necrosis factor α, TNFα）则在术后2个月内持续升高。

结论
无并发症择期PCI术后2个月时，中间型单核细胞数量显著升高。该类细胞在DES组中仍显著升高，但在DCB组中无此变化，提示不同的PCI治疗策略可能是调控术后炎症应答的潜在手段之一。