Document Detail


Relevance of hemostasis on restenosis in clinically stable patients undergoing elective PTCA.
MedLine Citation:
PMID:  18054069     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Secondary coronary thrombus formation is considered to be co-factor in the pathogenesis of restenosis after percutaneous transluminal coronary angioplasty (PTCA). Therefore systemic factors indicating a hypercoagulable disease state may be relevant for the process of coronary renarrowing. Even though experimental data suggest that in particular thrombin may be of major relevance for restenosis induced by mechanical injury, only little clinical data has been presented so far. METHODS AND RESULTS: In 60 consecutive patients, who had been clinical stable for at least 2 months, and who underwent elective and primarily successful PTCA, follow-up films were evaluated by means of quantitative coronary angiography in respect to a categorical and a continuous definition of restenosis, luminal narrowing >50% and late luminal loss respectively. Of the chosen laboratory variables prothrombin fragment 1+2 (1.3+/-0.5 vs. 0.9+/-0.4 mmol/l, p<0.001) red blood cell aggregation at low shear stress (13.5+/-2.9 vs. 11.6+/-2.8 units, p<0.05), and plasminogen-activator inhibitor (3.7+/-1.8 vs. 5.3+/-3.2 U/ml p<0.05) differentiated between patients with (n=18) and without restenosis (n=42). Late luminal loss correlated positively with prothrombin fragment 1+2 (r=0.41, p<0.001), plasminogen-activator inhibitor (r= -0.28, p<0.05) and plasmin-alpha2-antiplasmin complex (r=0.39, p<0.01). CONCLUSIONS: A hypercoagulable disease state and in particular thrombin generation characterize a high-risk group prone for restenosis in clinically stable coronary artery disease.
Authors:
F C Schoebel; A J Peters; I Kreis; F Gradaus; M Heins; T W Jax
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Publication Detail:
Type:  Journal Article     Date:  2007-12-03
Journal Detail:
Title:  Thrombosis research     Volume:  122     ISSN:  0049-3848     ISO Abbreviation:  Thromb. Res.     Publication Date:  2008  
Date Detail:
Created Date:  2008-06-03     Completed Date:  2008-09-15     Revised Date:  2009-11-19    
Medline Journal Info:
Nlm Unique ID:  0326377     Medline TA:  Thromb Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  229-36     Citation Subset:  IM    
Affiliation:
Heinrich Heine Universität Düsseldorf, Medizinische Klinik und Poliklinik B, Klinik für Kardiologie, Pneumologie und Angiologie, Moorenstrasse 5, 40225 Düsseldorf, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography / methods
Coronary Artery Disease / pathology
Coronary Restenosis*
Erythrocytes / cytology
Female
Hemostasis*
Humans
Lipid Metabolism
Male
Middle Aged
Plasminogen Activators / antagonists & inhibitors
Stress, Mechanical
Thrombin / chemistry,  metabolism
alpha-2-Antiplasmin / metabolism
Chemical
Reg. No./Substance:
0/alpha-2-Antiplasmin; EC 3.4.21.-/Plasminogen Activators; EC 3.4.21.5/Thrombin

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