Document Detail


The role of coagulation and inflammation after angioplasty in patients with peripheral arterial disease.
MedLine Citation:
PMID:  16729229     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Restenosis remains a frequent complication after angioplasty in peripheral arterial disease. Inflammation plays a critical role in the vascular response to injury. Effective medical treatment to improve patency after angioplasty is still elusive. The aims of this prospective clinical study were to investigate changes in blood coagulation and inflammatory markers after angioplasty and their significance for restenosis. METHODS: Thirty-four patients with peripheral arterial disease underwent angioplasty of the iliac and superficial femoral arteries. Ten patients undergoing diagnostic angiography were included in the study as controls. Plasma levels of tissue factor, prothrombin fragment 1 + 2, D-dimer, P-selectin, C-reactive protein (CRP), and fibrinogen were analyzed before and after angioplasty. Patients were followed up with angiography after 6 months to assess restenosis. RESULTS: CRP was elevated the day after angioplasty (6.6 mg/l, p = 0.0001) and tended to peak after 1 week (11 mg/l, p = 0.09). There was a significant increase of D-dimer and P-selectin 1-4 hr after angioplasty (0.4 mg/l, p = 0.001 and 68 ng/ml, p = 0.05, respectively). None of the biochemical markers was a statistically significant predictor of restenosis. CONCLUSION: We have observed a much more prolonged inflammatory response than previously noted, but only minor changes in coagulation activity after angioplasty. The biochemical markers, before and after angioplasty, were not related to restenosis. Further studies are needed to delineate the molecular mechanisms behind these observations and their involvement in thrombosis and restenosis. If these pathways are further defined, improved treatment strategies, including antithrombotic treatments and statins, could be tailored to modulate postprocedural inflammation.
Authors:
C M Wahlgren; M Sten-Linder; N Egberg; B Kalin; L Blohmé; J Swedenborg
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Cardiovascular and interventional radiology     Volume:  29     ISSN:  0174-1551     ISO Abbreviation:  Cardiovasc Intervent Radiol     Publication Date:    2006 Jul-Aug
Date Detail:
Created Date:  2006-05-26     Completed Date:  2006-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8003538     Medline TA:  Cardiovasc Intervent Radiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  530-5     Citation Subset:  IM    
Affiliation:
Department of Vascular Surgery, Karolinska University Hospital, Stockholm, 171 76, Sweden. carl.wahlgren@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiography
Angioplasty*
Arterial Occlusive Diseases / radiography,  surgery*
Blood Coagulation*
C-Reactive Protein / metabolism
Female
Femoral Artery*
Fibrin Fibrinogen Degradation Products / analysis
Humans
Iliac Artery*
Inflammation / epidemiology
Intermittent Claudication / radiography,  surgery
Ischemia / radiography,  surgery
Male
Middle Aged
Peripheral Vascular Diseases / radiography,  surgery*
Postoperative Complications
Recurrence
Treatment Outcome
Chemical
Reg. No./Substance:
0/Fibrin Fibrinogen Degradation Products; 0/fibrin fragment D; 9007-41-4/C-Reactive Protein

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


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