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1.
Thromb Haemost ; 105(5): 883-91, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21359408

RESUMEN

Percutaneous coronary intervention (PCI) represents the most important treatment of coronary artery stenosis today. But instent restenosis (ISR) is a limitation for the outcome. Fas and Fas Ligand have been implicated in apoptosis and vessel wall inflammation. Their role in ISR is not known so far. In this prospective study we studied 137 patients with stable coronary artery disease who underwent elective PCI. Blood samples were taken directly before and 24 hours after PCI. Soluble (s)Fas and sFas Ligand serum levels were measured by ELISA. Restenosis was evaluated six to eight months later either by coronary angiography or by exercise testing. During the follow-up period, 18 patients (13%) developed ISR. At baseline, patients with ISR had significantly lower median sFas, as well as sFas Ligand levels compared to patients without ISR (sFAS: ISR 492 pg/ml, no ISR 967 pg/ml, p=0.014; sFAS Ligand: ISR: 26 pg/ml, no ISR: 42 pg/ml, p=0.001). After PCI median sFas levels significantly decreased in patients with ISR compared to patients without ISR [ISR: -152 pg/ml (IQR -36 to -227), no ISR: -38 pg/ml (IQR -173 to +150 pg/ml), p=0.03]. sFas Ligand levels after PCI significantly increased in ISR patients compared to patients without ISR [ISR: 14 pg/ml (IQR -3 to +26 pg/ml), no ISR -6 pg/ml (IQR -22 to +21 pg/ml), p=0.014]. In conclusion, sFas and sFas Ligand seem to be associated with the development of ISR. Determination of serum levels before and after PCI might help identifying patients at higher risk of ISR.


Asunto(s)
Angioplastia , Enfermedad Coronaria/terapia , Reestenosis Coronaria/diagnóstico , Complicaciones Posoperatorias , Anciano , Biomarcadores/sangre , Angiografía Coronaria , Reestenosis Coronaria/etiología , Proteína Ligando Fas/sangre , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Stents/efectos adversos , Receptor fas/sangre
2.
J Thromb Haemost ; 6(3): 508-13, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18182031

RESUMEN

BACKGROUND: We tested the hypothesis that plasma levels of plasminogen activator inhibitor-1 (PAI-1) are influenced by percutaneous coronary intervention (PCI) with the implantation of drug eluting stents (DES) and are able to predict the occurrence of in-stent restenosis (ISR). METHODS AND RESULTS: PAI-1 active antigen plasma levels were determined in 75 patients before and 24 h after PCI with DES implantation. Patients with ISR after six to eight months (16%) showed significantly lower PAI-1 plasma levels before PCI (ISR, 11.7 +/- 8.1 ng mL(-1); non-ISR, 22.8 +/- 18.8 ng mL(-1); P <0.05). PAI-1 levels in the lowest tertile were associated with a 9.5-fold increased risk of ISR, independent of clinical risk factors, angiographic or procedural characteristics, compared to the highest tertile (P < 0.05). The induced change of PAI-1 active antigen 24 h after PCI was significantly higher in patients with ISR (ISR, +5.6 +/- 8.0 ng mL(-1); non-ISR, -3.2 +/- 12.1 ng mL(-1); P < 0.05) with positive correlation to late lumen loss (r = 0.30; P < 0.05). CONCLUSIONS: ISR after DES implantation is significantly related to plasma levels of PAI-1 active antigen before and after PCI. If confirmed by larger multicenter studies, the determination of PAI-1 plasma levels might be clinically helpful in the identification of patients at high risk of developing of ISR, even after DES implantation.


Asunto(s)
Reestenosis Coronaria/sangre , Reestenosis Coronaria/prevención & control , Stents Liberadores de Fármacos/efectos adversos , Inhibidor 1 de Activador Plasminogénico/sangre , Anciano , Angiografía/métodos , Clopidogrel , Femenino , Humanos , Masculino , Persona de Mediana Edad , Análisis de Regresión , Factores de Riesgo , Ticlopidina/análogos & derivados , Ticlopidina/farmacología , Factores de Tiempo , Activador de Tejido Plasminógeno/sangre , Resultado del Tratamiento
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