AbstractBackground:Interaction of advanced glycation end products (AGEs) with their receptor (RAGE) increases expression of inflammatory mediators (tumor necrosis factor alpha [TNF‐α] and soluble vascular cell adhesion molecule‐1 [sVCAM‐1]) and induces oxygen radicals that are implicated in atherosclerosis. Balloon‐injury‐induced atherosclerosis is associated with increased expression of AGEs and RAGE. The soluble receptor for AGE (sRAGE), which acts as a decoy for RAGE ligands (AGEs), prevents atherosclerosis in this model.Hypothesis:We evaluated: 1) whether post‐percutaneous coronary intervention (PCI) restenosis is associated with low pre‐PCI serum sRAGE, high serum AGEs, TNF‐α, and sVCAM‐1, and high AGE/sRAGE ratio; 2) whether pre‐PCI and post‐PCI levels of these markers are similar in patients with or without restenosis; and 3) whether sRAGE and AGE/sRAGE ratio have predictive value for post‐PCI restenosis.Methods:Angiography was performed in 46 patients with non–ST‐segment elevation myocardial infarction for assessment of restenosis. Serum sRAGE, AGEs, TNF‐α, and sVCAM‐1 were measured in these patients and 20 control subjects.Results:Nineteen of the 46 patients developed post‐PCI restenosis, which was associated with lower sRAGE and higher TNF‐α and sVCAM‐1 levels, and higher AGE/sRAGE ratio compared with patients without restenosis. Pre‐PCI and post‐PCI levels of these biomarkers were similar in both groups, except in patients with restenosis, in whom the post‐PCI level of sRAGE was lower and TNF‐α was higher than the pre‐PCI levels. The sensitivity and negative predictive value of sRAGE were 100%, and were higher than those of AGE/sRAGE ratio in identifying post‐PCI restenosis.Conclusions:Both low serum sRAGE levels and high AGE/sRAGE ratio have predictive value for post‐PCI restenosis. Copyright © 2008 Wiley Periodicals, Inc.This research was supported by grants from the Heart and Stroke Foundation of Saskatchewan and the Pollack Research Foundation, Saskatoon, Saskatchewan. The authors have no other funding, financial relationships, or conflicts of interest to disclose.