Cardiol Res

Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access

Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc

Journal website https://www.cardiologyres.org

Short Communication

Volume 14, Number 1, February 2023, pages 69-78

The Effects of Percutaneous Coronary Intervention on Biomarkers and Quality of Life in Patients With Chronic Total Coronary Artery Obstruction

Figure 1. Comparison of MMP-9 levels at baseline and 8 weeks later (pre-/post-test) between the PCI and without PCI groups. Bars show the mean, and the black lines show the standard deviation. PCI: percutaneous coronary intervention; MMP-9: matrix metalloproteinase-9.

Figure 2. Comparison of sST2 levels at baseline and 8 weeks later (pre-/post-test) between the PCI and without PCI groups. Bars show the mean, and the black lines show the standard deviation. PCI: percutaneous coronary intervention; sST2: soluble suppression tumorigenicity 2.

Figure 3. Comparison of NT-pro-BNP levels at baseline and 8 weeks later (pre-/post-test) between the PCI and without PCI groups. Bars show the mean, and the black lines show the standard deviation. PCI: percutaneous coronary intervention; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide.

**Table 1.** Baseline Characteristics of the Subject
Characteristics	PCI (n = 20)	Without PCI (n = 20)	P value
*Significance level of P < 0.05. CTO: chronic total obstruction; CCB: calcium channel blockers; ACE-I: ACE-inhibitors; ARBs: angiotensin receptors blocker; COX: cyclooxygenase; LAD: left anterior descending artery; RCA: right coronary artery; LCx: left circumflex; ACE: angiotensin-converting enzyme; PCI: percutaneous coronary intervention.
Age (years) (mean ± SD)	56.70 ± 2.20	59.70 ± 1.73	0.284
Gender (n, %)
Male	17 (47.2%)	19 (52.8%)	0.292
Female	3 (75%)	1 (25%)
Weight (kg) (mean ± SD)	62.70 ± 1.07	64.95 ± 1.49	0.230
Height (cm) (mean ± SD)	159.55 ± 0.93	158.75 ± 0.97	0.555
Body mass index (n, %)
Normal	11 (61.6%)	7 (38.9%)	0.314
Overweight	9 (42.9%)	12 (57.1%)
Obesity	0 (0.0%)	1 (100%)
CTO blood vessel (n, %)
LAD	15 (68.2%)	7 (31.8%)	0.028*
LCx	0 (0.0%)	2 (100%)
RCA	5 (31.3%)	11 (68.8%)
LVEF (%) (mean ± SD)	57.40 ± 1.45	59.89 ± 1.40	0.243
Comorbidity
Hypertension	16 (47.1%)	18 (52.9%)	0.376
Dyslipidemia	3 (37.5%)	5 (62.5%)	0.429
Type 2 DM	3 (37.5%)	5 (67.5%)	0.429
Therapy
COX-1 inhibitor	20 (50%)	20 (50%)	-
ADP receptor antagonist	20 (50%)	20 (50%)	-
ACE-I	9 (42.9%)	12 (57.1%)	0.342
ARBs	11 (55%)	9 (45%)	0.527
Beta-blocker	20 (50%)	20 (50%)	-
Statin	20 (50%)	20 (50%)
Nitrate	13 (44.8%)	16 (55.2%)	0.288
CCB	3 (33.3%)	6 (66.7%)	0.256
Trimetazidine	3 (60%)	2 (40%)	0.633

Table 1. Baseline Characteristics of the Subject

Characteristics

PCI (n = 20)

Without PCI (n = 20)

P value

*Significance level of P < 0.05. CTO: chronic total obstruction; CCB: calcium channel blockers; ACE-I: ACE-inhibitors; ARBs: angiotensin receptors blocker; COX: cyclooxygenase; LAD: left anterior descending artery; RCA: right coronary artery; LCx: left circumflex; ACE: angiotensin-converting enzyme; PCI: percutaneous coronary intervention.

Age (years) (mean ± SD)

56.70 ± 2.20

59.70 ± 1.73

0.284

Gender (n, %)

Male

17 (47.2%)

19 (52.8%)

0.292

Female

3 (75%)

1 (25%)

Weight (kg) (mean ± SD)

62.70 ± 1.07

64.95 ± 1.49

0.230

Height (cm) (mean ± SD)

159.55 ± 0.93

158.75 ± 0.97

0.555

Body mass index (n, %)

Normal

11 (61.6%)

7 (38.9%)

0.314

Overweight

9 (42.9%)

12 (57.1%)

Obesity

0 (0.0%)

1 (100%)

CTO blood vessel (n, %)

LAD

15 (68.2%)

7 (31.8%)

0.028*

LCx

0 (0.0%)

2 (100%)

RCA

5 (31.3%)

11 (68.8%)

LVEF (%) (mean ± SD)

57.40 ± 1.45

59.89 ± 1.40

0.243

Comorbidity

Hypertension

16 (47.1%)

18 (52.9%)

0.376

Dyslipidemia

3 (37.5%)

5 (62.5%)

0.429

Type 2 DM

3 (37.5%)

5 (67.5%)

0.429

Therapy

COX-1 inhibitor

20 (50%)

ADP receptor antagonist

20 (50%)

ACE-I

9 (42.9%)

12 (57.1%)

0.342

ARBs

11 (55%)

9 (45%)

0.527

Beta-blocker

20 (50%)

Statin

20 (50%)

Nitrate

13 (44.8%)

16 (55.2%)

0.288

CCB

3 (33.3%)

6 (66.7%)

0.256

Trimetazidine

3 (60%)

2 (40%)

0.633

**Table 2.** Blood Laboratory Test
Parameter	PCI (n = 20)	Without PCI (n = 20)	P
Hb: hemoglobin; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; PCI: percutaneous coronary intervention.
Hb (g/dL)	13.91 ± 0.27	13.94 ± 0.28	0.942
Total cholesterol (g/dL)	161.90 ± 6.29	166.5 ± 9.65	0.692
HDL-C (g/dL)	38.60 ± 2.34	39.15 ± 1.90	0.856
LDL-C (g/dL)	101.45 ± 6.26	110.45 ± 7.21	0.352
Triglyceride	159.30 ± 17.13	143.65 ± 14.79	0.494
Urea (mg/dL)	15.31 ± 1.89	13.08 ± 1.23	0.329
Creatinine (mg/dL)	1.66 ± 0.59	1.02 ± 0.06	0.297

Table 2. Blood Laboratory Test

Parameter

PCI (n = 20)

Without PCI (n = 20)

Hb: hemoglobin; HDL-C: high-density lipoprotein cholesterol; LDL-C: low-density lipoprotein cholesterol; PCI: percutaneous coronary intervention.

Hb (g/dL)

13.91 ± 0.27

13.94 ± 0.28

0.942

Total cholesterol (g/dL)

161.90 ± 6.29

166.5 ± 9.65

0.692

HDL-C (g/dL)

38.60 ± 2.34

39.15 ± 1.90

0.856

LDL-C (g/dL)

101.45 ± 6.26

110.45 ± 7.21

0.352

Triglyceride

159.30 ± 17.13

143.65 ± 14.79

0.494

Urea (mg/dL)

15.31 ± 1.89

13.08 ± 1.23

0.329

Creatinine (mg/dL)

1.66 ± 0.59

1.02 ± 0.06

0.297

**Table 3.** Baseline Level of Serum MMP-9, sST2, and NT-pro-BNP in PCI and Without PCI Groups
Biomarker level	PCI	Without PCI	Mean difference	95% CI	P value
MMP-9: matrix metalloproteinase-9; sST-2: soluble suppression of tumorigenesis-2; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide; PCI: percutaneous coronary intervention; CI: confidence interval.
MMP-9 (ng/mL)	12.07 ± 1.27	11.36 ± 1.51	1.11	-2.3 - 5.73	0.394
sST2 (ng/mL)	37.65 ± 20.00	37.63 ± 15.39	0.02	-11.39 - 11.45	0.996
NT-pro-BNP (ng/mL)	0.63 ± 0.23	0.49 ± 1.93	0.14	-0.2 - 0.31	0.099

Table 3. Baseline Level of Serum MMP-9, sST2, and NT-pro-BNP in PCI and Without PCI Groups

Biomarker level

PCI

Without PCI

Mean difference

95% CI

P value

MMP-9: matrix metalloproteinase-9; sST-2: soluble suppression of tumorigenesis-2; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide; PCI: percutaneous coronary intervention; CI: confidence interval.

MMP-9 (ng/mL)

12.07 ± 1.27

11.36 ± 1.51

1.11

-2.3 - 5.73

0.394

sST2 (ng/mL)

37.65 ± 20.00

37.63 ± 15.39

0.02

-11.39 - 11.45

0.996

NT-pro-BNP (ng/mL)

0.63 ± 0.23

0.49 ± 1.93

0.14

-0.2 - 0.31

0.099

**Table 4.** Serum MMP-9, sST2, and NT-pro-BNP Levels in PCI and Without PCI Groups 8 Weeks Later
Biomarker level	PCI	Without PCI	Mean difference	95% CI	P value
*Significant (P < 0.05). MMP-9: matrix metalloproteinase-9; sST-2: soluble suppression of tumorigenesis-2; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide; PCI: percutaneous coronary intervention; CI: confidence interval.
MMP-9 (ng/mL)	9.91 ± 5.19	11.69 ± 6.51	2.78	1.01 - 5.98	0.045*
sST2 (ng/mL)	29.74 ± 15.17	34.03 ± 20.24	5.65	1.75 - 7.15	0.045*
NT-pro-BNP (ng/mL)	0.24 ± 0.10	0.56 ± 0.23	0.31	0.20 - 0.4	< 0.001*

Table 4. Serum MMP-9, sST2, and NT-pro-BNP Levels in PCI and Without PCI Groups 8 Weeks Later

Biomarker level

PCI

Without PCI

Mean difference

95% CI

P value

*Significant (P < 0.05). MMP-9: matrix metalloproteinase-9; sST-2: soluble suppression of tumorigenesis-2; NT-pro-BNP: N-terminal pro-B-type natriuretic peptide; PCI: percutaneous coronary intervention; CI: confidence interval.

MMP-9 (ng/mL)

9.91 ± 5.19

11.69 ± 6.51

2.78

1.01 - 5.98

0.045*

sST2 (ng/mL)

29.74 ± 15.17

34.03 ± 20.24

5.65

1.75 - 7.15

0.045*

NT-pro-BNP (ng/mL)

0.24 ± 0.10

0.56 ± 0.23

0.31

0.20 - 0.4

< 0.001*

**Table 5.** Comparison of Physical Activity Limitation, Angina Severity, Therapy Satisfaction, and Quality of Life Between the PCI and Without PCI Groups at Baseline and After 8 Weeks
Variable	PCI	Without PCI	Mean difference	95% CI	P value
*Significance level of P < 0.05. PCI: percutaneous coronary intervention; CI: confidence interval.
Week 0
Physical activity limitation	69.95 ± 8.30	66.05 ± 8.24	3.9	-	0.061
Angina severity	50.00 ± 3.53	50.85 ± 4.12	0.85	-	0.529
Therapy satisfaction	52.80 ± 4.12	50.75 ± 4.71	2.05	0.78 - 4.88	0.151
Quality of life	49.85 ± 9.19	48.15 ± 7.01	1.70	-	0.663
Week 8
Physical activity limitation	68.81 ± 8.14	64.10 ± 8.12	3.72	-	0.063
Angina severity	52.85 ± 4.12	56.1 ± 3.75	3.25	-	0.039*
Therapy satisfaction	53.30 ± 3.97	51.35 ± 4.79	1.95	0.86 - 4.76	0.169
Quality of life	50.80 ± 9.34	49.1 ± 7.19	1.43	-	0.678

Table 5. Comparison of Physical Activity Limitation, Angina Severity, Therapy Satisfaction, and Quality of Life Between the PCI and Without PCI Groups at Baseline and After 8 Weeks

Variable

PCI

Without PCI

Mean difference

95% CI

P value

*Significance level of P < 0.05. PCI: percutaneous coronary intervention; CI: confidence interval.

Week 0

Physical activity limitation

69.95 ± 8.30

66.05 ± 8.24

3.9

0.061

Angina severity

50.00 ± 3.53

50.85 ± 4.12

0.85

0.529

Therapy satisfaction

52.80 ± 4.12

50.75 ± 4.71

2.05

0.78 - 4.88

0.151

Quality of life

49.85 ± 9.19

48.15 ± 7.01

1.70

0.663

Week 8

Physical activity limitation

68.81 ± 8.14

64.10 ± 8.12

3.72

0.063

Angina severity

52.85 ± 4.12

56.1 ± 3.75

3.25

0.039*

Therapy satisfaction

53.30 ± 3.97

51.35 ± 4.79

1.95

0.86 - 4.76

0.169

Quality of life

50.80 ± 9.34

49.1 ± 7.19

1.43

0.678