Impairment of early fibrinolytic activation after PTCA

A mechanism for restenosis-related clinical recurrence?

M. Capanni, E. Antonucci, L. Chiarugi, V. Boddi, R. Abbate, D. Prisco, C. Giglioli, R. P. Dabizzi, M. Margheri, I. Simonetti, G. F. Gensini

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Abstract

Objective: This study was aimed to investigate the acute effect of PTCA on clotting activation and fibrinolytic system and the possible role of modifications of haemostasis in relation to restenosis-related clinical recurrence after PTCA. Setting: Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Florence, Italy. Material and methods: In 83 unselected patients (70 men and 13 women) undergoing PTCA, blood clotting (fibrinogen, F1+2, TAT) and fibrinolytic activation (D-dimer, ELT, PAI-1, t-PA) were assayed before and immediately after PTCA. Results: At the end of the procedure there was a significant decrease in plasma levels of fibrinogen (P <0.0001), F1+2 (P<0.0001), TAT (P<0.0001), PAI-1 (P <0.0001) and t-PA (P <0.001), a shortening of ELT (P <0.0001) and a significant increase in D-dimer concentration (P <0.0005). Post-procedural PAI-1 activity levels were significantly higher in patients with subsequent clinical recurrence owing to restenosis than in those without (P <0.0005); similarly, patients with restenosis showed lower t-PA levels (P <0.0005) and longer ELT (P <0.05) after PTCA than those without. An earlier occurrence of clinical recurrence owing to restenosis was observed in patients with an increase or no variation of PAI-1 levels at the end of the procedure. Conclusion: These results suggest that the early fibrinolytic response to balloon injury is a relevant determinant of the risk of clinical recurrence owing to restenosis after PTCA, possibly by determining 'per se' a longer local persistence of thrombus and by triggering a release of mediators involved in the proliferation of smooth muscle cells.

Original languageEnglish
Pages (from-to)8-14
Number of pages7
JournalFibrinolysis and Proteolysis
Volume13
Issue number1
Publication statusPublished - 1999

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Plasminogen Activator Inhibitor 1
Recurrence
Fibrinogen
Blood Coagulation
Hemostasis
Italy
Smooth Muscle Myocytes
Thrombosis
Wounds and Injuries
fibrin fragment D

ASJC Scopus subject areas

  • Hematology

Cite this

Capanni, M., Antonucci, E., Chiarugi, L., Boddi, V., Abbate, R., Prisco, D., ... Gensini, G. F. (1999). Impairment of early fibrinolytic activation after PTCA: A mechanism for restenosis-related clinical recurrence? Fibrinolysis and Proteolysis, 13(1), 8-14.

Impairment of early fibrinolytic activation after PTCA : A mechanism for restenosis-related clinical recurrence? / Capanni, M.; Antonucci, E.; Chiarugi, L.; Boddi, V.; Abbate, R.; Prisco, D.; Giglioli, C.; Dabizzi, R. P.; Margheri, M.; Simonetti, I.; Gensini, G. F.

In: Fibrinolysis and Proteolysis, Vol. 13, No. 1, 1999, p. 8-14.

Research output: Contribution to journalArticle

Capanni, M, Antonucci, E, Chiarugi, L, Boddi, V, Abbate, R, Prisco, D, Giglioli, C, Dabizzi, RP, Margheri, M, Simonetti, I & Gensini, GF 1999, 'Impairment of early fibrinolytic activation after PTCA: A mechanism for restenosis-related clinical recurrence?', Fibrinolysis and Proteolysis, vol. 13, no. 1, pp. 8-14.
Capanni, M. ; Antonucci, E. ; Chiarugi, L. ; Boddi, V. ; Abbate, R. ; Prisco, D. ; Giglioli, C. ; Dabizzi, R. P. ; Margheri, M. ; Simonetti, I. ; Gensini, G. F. / Impairment of early fibrinolytic activation after PTCA : A mechanism for restenosis-related clinical recurrence?. In: Fibrinolysis and Proteolysis. 1999 ; Vol. 13, No. 1. pp. 8-14.
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title = "Impairment of early fibrinolytic activation after PTCA: A mechanism for restenosis-related clinical recurrence?",
abstract = "Objective: This study was aimed to investigate the acute effect of PTCA on clotting activation and fibrinolytic system and the possible role of modifications of haemostasis in relation to restenosis-related clinical recurrence after PTCA. Setting: Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Florence, Italy. Material and methods: In 83 unselected patients (70 men and 13 women) undergoing PTCA, blood clotting (fibrinogen, F1+2, TAT) and fibrinolytic activation (D-dimer, ELT, PAI-1, t-PA) were assayed before and immediately after PTCA. Results: At the end of the procedure there was a significant decrease in plasma levels of fibrinogen (P <0.0001), F1+2 (P<0.0001), TAT (P<0.0001), PAI-1 (P <0.0001) and t-PA (P <0.001), a shortening of ELT (P <0.0001) and a significant increase in D-dimer concentration (P <0.0005). Post-procedural PAI-1 activity levels were significantly higher in patients with subsequent clinical recurrence owing to restenosis than in those without (P <0.0005); similarly, patients with restenosis showed lower t-PA levels (P <0.0005) and longer ELT (P <0.05) after PTCA than those without. An earlier occurrence of clinical recurrence owing to restenosis was observed in patients with an increase or no variation of PAI-1 levels at the end of the procedure. Conclusion: These results suggest that the early fibrinolytic response to balloon injury is a relevant determinant of the risk of clinical recurrence owing to restenosis after PTCA, possibly by determining 'per se' a longer local persistence of thrombus and by triggering a release of mediators involved in the proliferation of smooth muscle cells.",
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T1 - Impairment of early fibrinolytic activation after PTCA

T2 - A mechanism for restenosis-related clinical recurrence?

AU - Capanni, M.

AU - Antonucci, E.

AU - Chiarugi, L.

AU - Boddi, V.

AU - Abbate, R.

AU - Prisco, D.

AU - Giglioli, C.

AU - Dabizzi, R. P.

AU - Margheri, M.

AU - Simonetti, I.

AU - Gensini, G. F.

PY - 1999

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N2 - Objective: This study was aimed to investigate the acute effect of PTCA on clotting activation and fibrinolytic system and the possible role of modifications of haemostasis in relation to restenosis-related clinical recurrence after PTCA. Setting: Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Florence, Italy. Material and methods: In 83 unselected patients (70 men and 13 women) undergoing PTCA, blood clotting (fibrinogen, F1+2, TAT) and fibrinolytic activation (D-dimer, ELT, PAI-1, t-PA) were assayed before and immediately after PTCA. Results: At the end of the procedure there was a significant decrease in plasma levels of fibrinogen (P <0.0001), F1+2 (P<0.0001), TAT (P<0.0001), PAI-1 (P <0.0001) and t-PA (P <0.001), a shortening of ELT (P <0.0001) and a significant increase in D-dimer concentration (P <0.0005). Post-procedural PAI-1 activity levels were significantly higher in patients with subsequent clinical recurrence owing to restenosis than in those without (P <0.0005); similarly, patients with restenosis showed lower t-PA levels (P <0.0005) and longer ELT (P <0.05) after PTCA than those without. An earlier occurrence of clinical recurrence owing to restenosis was observed in patients with an increase or no variation of PAI-1 levels at the end of the procedure. Conclusion: These results suggest that the early fibrinolytic response to balloon injury is a relevant determinant of the risk of clinical recurrence owing to restenosis after PTCA, possibly by determining 'per se' a longer local persistence of thrombus and by triggering a release of mediators involved in the proliferation of smooth muscle cells.

AB - Objective: This study was aimed to investigate the acute effect of PTCA on clotting activation and fibrinolytic system and the possible role of modifications of haemostasis in relation to restenosis-related clinical recurrence after PTCA. Setting: Istituto di Clinica Medica Generale e Cardiologia, University of Florence, Florence, Italy. Material and methods: In 83 unselected patients (70 men and 13 women) undergoing PTCA, blood clotting (fibrinogen, F1+2, TAT) and fibrinolytic activation (D-dimer, ELT, PAI-1, t-PA) were assayed before and immediately after PTCA. Results: At the end of the procedure there was a significant decrease in plasma levels of fibrinogen (P <0.0001), F1+2 (P<0.0001), TAT (P<0.0001), PAI-1 (P <0.0001) and t-PA (P <0.001), a shortening of ELT (P <0.0001) and a significant increase in D-dimer concentration (P <0.0005). Post-procedural PAI-1 activity levels were significantly higher in patients with subsequent clinical recurrence owing to restenosis than in those without (P <0.0005); similarly, patients with restenosis showed lower t-PA levels (P <0.0005) and longer ELT (P <0.05) after PTCA than those without. An earlier occurrence of clinical recurrence owing to restenosis was observed in patients with an increase or no variation of PAI-1 levels at the end of the procedure. Conclusion: These results suggest that the early fibrinolytic response to balloon injury is a relevant determinant of the risk of clinical recurrence owing to restenosis after PTCA, possibly by determining 'per se' a longer local persistence of thrombus and by triggering a release of mediators involved in the proliferation of smooth muscle cells.

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