Document Detail


D-dimer increase after percutaneous transluminal angioplasty and clinical recurrence after primary revascularization in acute myocardial infarction? A pilot study.
MedLine Citation:
PMID:  11918281     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been reported that the increase of plasminogen activator inhibitor-1 activity immediately after elective coronary angioplasty is related to subsequent clinical recurrence in patients with chronic coronary artery disease. The aims of our study were to evaluate the behavior of plasminogen activator inhibitor-1 and D-Dimer after revascularization in acute myocardial infarction patients treated with angioplasty and stenting and if this behavior is predictive of subsequent clinical recurrence. D-Dimer and plasminogen activator inhibitor-1 activity were evaluated in two groups of patients. Group 1 consisted of 54 consecutive patients undergoing primary angioplasty for acute myocardial infarction and Group 2 consisted of 48 patients undergoing elective angioplasty. Patients underwent control coronary angiography only in the case of clinical recurrence and/or positivity of provocative tests. D-Dimer and plasminogen activator inhibitor-1 baseline levels were significantly higher in group 1 than in group 2 (P<0.0005 and P<0.05, respectively). The percentage of group 1 patients with a post-procedural increase in D-Dimer was significantly higher among those with subsequent clinical recurrence with restenosis (61%) than among those with no recurrence (25%, P<0.05). No difference was observed in group 2. The percentage of group 2 patients in whom no decrease of plasminogen activator inhibitor-1 was observed after angioplasty was significantly higher (83%) among those with subsequent recurrence than among those with no recurrence (38%, P<0.05). This pattern was not observed in group 1. In conclusion, the role of early changes in plasminogen activator inhibitor-1 in predicting clinical recurrence after primary angioplasty in acute myocardial infarction patients is less clear than that observed after elective angioplasty. A significant role seems to be played by a more-marked clotting activation with increased fibrin formation.
Authors:
D Prisco; E Antonucci; S Fedi; M Margheri; C Giglioli; M Comeglio; A Lombardi; M Chioccioli; R Abbate; G F Gensini
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical and experimental medicine     Volume:  1     ISSN:  1591-8890     ISO Abbreviation:  Clin. Exp. Med.     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-03-28     Completed Date:  2002-06-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100973405     Medline TA:  Clin Exp Med     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  219-24     Citation Subset:  IM    
Affiliation:
Thrombosis Center, Department of Medical and Surgical Critical Care, University of Florence, Italy. d.prisco@dfe.unifi.it
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Angioplasty, Transluminal, Percutaneous Coronary / adverse effects*
Coronary Artery Disease / blood,  therapy
Coronary Restenosis / blood,  etiology
Female
Fibrin Fibrinogen Degradation Products / metabolism*
Hemostasis
Humans
Male
Middle Aged
Myocardial Infarction / blood*,  therapy*
Pilot Projects
Plasminogen Activator Inhibitor 1 / blood
Recurrence
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/Plasminogen Activator Inhibitor 1; 0/fibrin fragment D

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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