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 language | English |
|---|---|
| Pages (from-to) | 8-14 |
| Number of pages | 7 |
| Journal | Fibrinolysis and Proteolysis |
| Volume | 13 |
| Issue number | 1 |
| Publication status | Published - 1999 |
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ASJC Scopus subject areas
- Hematology
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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 journal › Article
}
TY - JOUR
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
Y1 - 1999
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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M3 - Article
VL - 13
SP - 8
EP - 14
JO - Fibrinolysis and Proteolysis
JF - Fibrinolysis and Proteolysis
SN - 1369-0191
IS - 1
ER -