Changes in the Fibrinolytic System in Patients with Peripheral Arterial Occlusive Disease Undergoing Percutaneous Transluminal Angioplasty

Roller, Regina E.; Janisch, S.; Carroll, Veronica A.; Kvas, Erich; Pilger, Ernst; Binder, Bernd R.; Wojta, Johann

doi:10.1016/s0049-3848(99)00002-x

Cited by 13 publications

(9 citation statements)

References 28 publications

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“…Plasminogen activator inhibitor type 1 (PAI-1) is an essential component of the coagulation cascade inhibiting fibrinolysis in the circulation by rapid deactivation of tissue type plasminogen activator (6). Increased PAI-1 expression in the vascular wall and elevated PAI-1 serum levels are known to be a potential progenitor of restenosis after percutaneous interventions (6)(7)(8)(9)(10)(11)(12)(13). A functional polymorphism at nucleotide position (-675) in the PAI-1 gene promoter (4G/5G) was suggested to be involved pathogenetically in cardiovascular disease (14)(15)(16)(17).…”

Section: Discussionmentioning

confidence: 99%

“…Plasminogen activator inhibitor 1 (PAI-1), a rapid inhibitor of tissue-type plasminogen activator, is elevated within atherosclerotic vessels and increases neointima formation after balloon injury (6,7). Consistently, PAI-1 plasma levels have been demonstrated to predict restenosis after percutaneous revascularisa-tion in the coronary and peripheral vessel area (6,(8)(9)(10)(11)(12)(13). However, the potential role of a functional polymorphism in the PAI-1 gene promoter (4G/5G), which has been suggested to correlate with the cardiovascular risk (14)(15)(16)(17), is indeterminate with regard to its impact on early and late PTA failure (18).…”

Section: Introductionmentioning

confidence: 97%

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Plasminogen activator inhibitor-1 and outcome after femoropopliteal angioplasty: analysis of genotype and plasma levels

Mlekusch¹,

Schillinger²,

Exner³

et al. 2003

Thromb Haemost

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Plasminogen activator inhibitor-1 (PAI-1) is suggested to be involved in the pathophysiology of early thrombosis and late restenosis after percutaneous transluminal angioplasty (PTA). The role of the PAI-1 promoter genotype in this context is indeterminate. We investigated the association of the (4G/5G) polymorphism at nucleotide position (-675) in the PAI-1 gene promoter, PAI-1 plasma levels, and postangioplasty outcome after femoropopliteal PTA. We studied 251 consecutive patients who underwent femoro-popliteal PTA. In a subgroup of 86 patients PAI-1 plasma levels at baseline, 8, 24 and 48 hours postintervention were measured and correlated to the genotype. Patients were followed for early thrombosis and the late restenosis (> or =50%) within 12 months. Multivariate Cox proportional hazards analysis was performed to assess the association between the PAI-1 genotype and PTA failure. Results show that the PAI-1 genotype was neither associated with PAI-1 plasma levels (p=0.40) nor the change of PAI-1 from baseline to 8 (p=0.39), 24 (p=0.86) and 48 hours (p=0.89). Three out of 35 homozygous (4G/4G) patients (9%) had early thrombotic reocclusions, compared to two out of 153 heterozygous (4G/5G) patients (1%) and none of the 63 homozygous (5G/5G) patients (p=0.007). Restenosis after median 5 months (interquartile range 3 to 9) was found in 117 patients (42%), without significant association between the PAI-1 genotype and late postangioplasty failure (Log Rank p=0.95). We can conclude that carriers of the 4G allele exhibited a higher frequency of early thrombotic reocclusions after percutaneous angioplasty. However, the PAI-1 gene promoter polymorphism (4G/5G) was not associated with PAI-1 plasma levels or late postangioplasty restenosis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Plasminogen activator inhibitor-1 and outcome after femoropopliteal angioplasty: analysis of genotype and plasma levels

Mlekusch¹,

Schillinger²,

Exner³

et al. 2003

Thromb Haemost

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“…Plasma PAI-1 is influenced by a number of hormones and cytokines (112) and has been associated with hyperglycaemia, hypertriglyceridaemia and insulin resistance (107,113), which are all components of the metabolic syndrome. Both tPA and PAI-1 have previously been associated with prevalent PAD and severity of disease and PAI-1 activity has been correlated with re-stenosis after PTA (97,114). Although tPA was not associated with incident PAD in the Edinburgh Artery Study, elevated tPA levels have been associated with the presence of and increasing severity of PAD (56).…”

Section: Fibrinolysismentioning

confidence: 92%

“…Raised pre-interventional levels of fibrinogen are related to a greater risk of re-stenosis following PTA (96,97), with patency rates being significantly associated with fibrinogen levels, independent of other factors (98). Importantly, the 17-year follow-up to the Edinburgh Artery Study reported strong and independent associations between fibrinogen and incident PAD (56).…”

Section: Fibrinogenmentioning

confidence: 99%

Peripheral arterial disease and Virchow’s triad

Bennett

Silverman

Gill³

et al. 2009

Thromb Haemost

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SummaryPeripheral arterial disease (PAD) is an important global healthcare problem associated with considerable morbidity and mortality. This disease is an important manifestation of atherosclerosis and the pathophysiological processes involved in its development, progression and complications are atherothrombosis and thromboembolism. Over 150 years ago, Virchow described a triad of abnormalities (abnormal blood flow, abnormal vessel wall and abnormal blood constituents) associated with KeywordsArterial thrombosis, clinical studies, risk factors thrombus formation (thrombogenesis). An improvement in biochemical techniques has allowed quantification of various components of Virchow's triad, and as a consequence, there has been increasing interest in the measurement of such biomarkers in understanding the development and progression of PAD, as well as its symptomatic complications. This review discusses quantifiable components of Virchow's triad that have been associated with PAD and their clinical utility as risk factors for PAD.

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“…Interestingly, the grade of fibrinolysis impairment has been reported to correlate with the severity of claudication [174]. Finally, PAI-1 activity measured 24 and 48 hours after PTA in PAD patients emerged as the only significant predictor of restenosis [175].…”

Section: Tissue Plasminogen Activator (Tpa) Plasminogen Activator Inmentioning

confidence: 97%

Associations of Thrombotic-Hemostatic Factors with Cardiovascular Disease~!2009-10-29~!2009-12-22~!2010-04-08~!

Lioudaki¹,

Ganotakis²

2012

TOCCHEMJ

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Cardiovascular disease (CVD) remains a leading cause of global morbidity and mortality despite identification of major cardiovascular (CV) risk factors and risk reduction via appropriate interventions. During the last years several markers have been studied as potential predictors of CV events. Hemostatic and thrombotic factors such as fibrinogen, homocysteine, factor VII, von Willebrand, tissue plasminogen activator, plasminogen activator inhibitor -1, D-dimer and lipoprotein ( ) have been found to be closely related to CVD. Many epidemiological studies have indicated that raised levels of these factors are associated with higher incidence of CVD, while some others have yielded conflicting results. As a consequence, it remains obscure whether they contribute to prediction of future CV events on top of conventional risk factors. Although data suggest that most of them are somehow implicated in CVD pathophysiology, it is not clearly defined yet whether treatment of abnormal levels leads to CV risk reduction. As a result measurement and treatment of these factors are justified only in exceptional cases. Further investigation is required in order to conclude whether and which of these factors may claim a position in everyday clinical practice.

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Changes in the Fibrinolytic System in Patients with Peripheral Arterial Occlusive Disease Undergoing Percutaneous Transluminal Angioplasty

Cited by 13 publications

References 28 publications

Plasminogen activator inhibitor-1 and outcome after femoropopliteal angioplasty: analysis of genotype and plasma levels

Plasminogen activator inhibitor-1 and outcome after femoropopliteal angioplasty: analysis of genotype and plasma levels

Peripheral arterial disease and Virchow’s triad

Associations of Thrombotic-Hemostatic Factors with Cardiovascular Disease~!2009-10-29~!2009-12-22~!2010-04-08~!

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