Annals of dermatology

Korean Dermatological Association (대한피부과학회)
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Relation of Nickel Allergy with in-Stent Restenosis in Patients Treated with Cobalt Chromium Stents

  • Aliagaogilu, Cihangir (Department of Dermatology, Duzce University Medical Faculty) ;
  • Turan, Hakan (Department of Dermatology, Duzce University Medical Faculty) ;
  • Erden, Ismail (Department of Cardiology, Duzce University Medical Faculty) ;
  • Albayrak, Hulya (Department of Dermatology, Duzce University Medical Faculty) ;
  • Ozhan, Hakan (Department of Cardiology, Duzce University Medical Faculty) ;
  • Basiar, Cengiz (Department of Cardiology, Duzce University Medical Faculty) ;
  • Gurlevik, Zehra (Department of Dermatology, Duzce University Medical Faculty) ;
  • Alcelik, Aysiegul (Department of Cardiology, Duzce University Medical Faculty)
  • Published : 2012.11.30
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Abstract

Background: In-stent restenosis (ISR) is the major limitation of percutaneous coronary stenting procedure. The elements like nickel, chromate and molybdenum are known to cause contact allergy. Hypersensitivity reaction, against these metal ions, may be one of the reasons of ISR. Cobalt chromium coronary stents, which are increasingly being used in percutaneous coronary interventions, have more nickel amount than the stainless steel stents. Objective: We aimed to investigate the association between nickel hypersensitivity reaction and ISR in patients treated with cobalt chromium coronary stents. Methods: Epicutaneous patch tests for nickel were applied to 31 patients who had undergone elective cobalt chromium coronary stent implantation and had ISR in control angiogram. Thirty patients, without ISR, were included as the control group. Patch test results and other clinical variables were compared. Results: There was no statistically significant difference of the mean age, sex, body mass index, rate of hypercholesterolemia, diabetes, hypertension and smoking between the patients with and without ISR. All other lesion characteristics were similar in the 2 groups. According to the patch test results, 7 patients had nickel contact allergy. All of these patients were in the ISR group, which was statistically significant (p<0.006). Conclusion: Patients treated with cobalt chromium coronary stents and had ISR were found to have significantly more nickel allergy than the control group. Nickel allergy may play role in restenosis pathophysiology.

Keywords

References

  1. Koster R, Vieluf D, Kiehn M, Sommerauer M, Kahler J, Baldus S, et al. Nickel and molybdenum contact allergies in patients with coronary in-stent restenosis. Lancet 2000;356:1895-1897. https://doi.org/10.1016/S0140-6736(00)03262-1
  2. Hillen U, Haude M, Erbel R, Goos M. Evaluation of metal allergies in patients with coronary stents. Contact Dermatitis 2002;47:353-6. https://doi.org/10.1034/j.1600-0536.2002.470607.x
  3. Saito T, Hokimoto S, Oshima S, Noda K, Kojyo Y, Matsunaga K. Metal allergic reaction in chronic refractory in-stent restenosis. Cardiovasc Revasc Med 2009;10:17-22. https://doi.org/10.1016/j.carrev.2008.01.004
  4. Norgaz T, Hobikoglu G, Serdar ZA, Aksu H, Alper AT, Ozer O, et al. Is there a link between nickel allergy and coronary stent restenosis? Tohoku J Exp Med 2005;206:243-246. https://doi.org/10.1620/tjem.206.243
  5. Iijima R, Ikari Y, Amiya E, Tanimoto S, Nakazawa G, Kyono H, et al. The impact of metallic allergy on stent implantation: metal allergy and recurrence of in-stent restenosis. Int J Cardiol 2005;104:319-325. https://doi.org/10.1016/j.ijcard.2004.12.034
  6. Honari G, Ellis SG, Wilkoff BL, Aronica MA, Svensson LG, Taylor JS. Hypersensitivity reactions associated with endovascular devices. Contact Dermatitis 2008;59:7-22. https://doi.org/10.1111/j.1600-0536.2008.01351.x
  7. Takagi T, Yamamuro A, Tamita K, Katayama M, Morioka S. Thiazolidinedione treatment attenuates diffuse neointimal hyperplasia in restenotic lesions after coronary stent implantation in type 2 diabetic patients: an intravascular ultrasound study. J Cardiol 2005;45:139-147.
  8. Svedman C, Ekqvist S, Möller H, Björk J, Pripp CM, Gruvberger B, et al. A correlation found between contact allergy to stent material and restenosis of the coronary arteries. Contact Dermatitis 2009;60:158-164. https://doi.org/10.1111/j.1600-0536.2008.01502.x
  9. Wataha JC, O'Dell NL, Singh BB, Ghazi M, Whitford GM, Lockwood PE. Relating nickel-induced tissue inflammation to nickel release in vivo. J Biomed Mater Res 2001;58: 537-544. https://doi.org/10.1002/jbm.1052
  10. Messer RL, Wataha JC, Lewis JB, Lockwood PE, Caughman GB, Tseng WY. Effect of vascular stent alloys on expression of cellular adhesion molecules by endothelial cells. J Long Term Eff Med Implants 2005;15:39-47. https://doi.org/10.1615/JLongTermEffMedImplants.v15.i1.50
  11. Nguyen SH, Dang TP, MacPherson C, Maibach H, Maibach HI. Prevalence of patch test results from 1970 to 2002 in a multi-centre population in North America (NACDG). Contact Dermatitis 2008;58:101-106.

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