Fibrinogen Values in Patients with and without Restenosis following Percutaneous Transluminal Coronary Angioplastγ

Abstract

Fibrinogen has turned out to be an independent risk factor for coronary heart disease (CHD). It is not known whether or not this parameter could be a prognostic factor for restenosis following percutaneous translumianl coronary angioplasty (PTCA), which represents the main problem limiting the long-term efficacy of this procedure. Therefore, we studied fibrinogen concentrations in a series of 50 males (mean age: 55, range: 38-70 years) with CHD and successful PTCA. Follow-up coronary angiography was performed 12 months following PTCA. Twenty-two patients had restenosis, and 28 patients were without restenosis. Both groups did not differ significantly in medical history (smoking habits, hypertension, positive family history for cardiovascular diseases), in routine lipid profile (total cholesterol, HDL cholesterol, LDL cholesterol, triglycerides, apolipoproteins Al and B). Fibrinogen values were 405 ± 128 mg/dl (range: 202-725) in patients with restenosis and 352 ± 94 mg/dl (range: 187-568) in patients without restenosis (not significant). Elevated fibrinogen levels of more than 400 mg/dl were found in 8 patients in each group. Although fibrinogen is a proven marker for CHD in men, fibrinogen is not a risk factor for restenosis following PTCA.

Influence of a history of smoking on short term (six month) clinical and angiographic outcome after successful coronary angioplasty

“…What influence these variables may have on the clinical and angiographic outcome after intervention is unclear. Although increased fibrinogen concentrations have not been associated with a higher restenosis rate in a small series,35 raised white cell counts36 are known to be strong predictors of myocardial infarction37 and to be a marker of important cellular injury.…”

Usefulness of Platelet Distribution Width and Fibrinogen in Predicting In-stent Restenosis With Stable Angina and Type 2 Patients With Diabetes Mellitus

“…The relationship between fibrinogen levels and ISR and the pathophysiological explanation of ISR was a controversial issue. There were also some studies that have found no significant association between fibrinogen levels and ISR, but these studies all have some limitations, such as the limitation of sample size and other factors that may affect the final results ( 35 , 36 ).…”

–455 G/A polymorphism and preprocedural plasma levels of fibrinogen show no association with the risk of clinical restenosis in patients with coronary stent placement

“…Someauthors of smaller or comparablesized studieshavefound apositive association (13,20,23,24),while othershavenot (25)(26)(27)(28).Inour large study,w edid not showthat patients with the Aallele had higher fibrinogen plasma levels. Theusefulness of preprocedural fibrinogen levels to predict risk of restenosis after PCI is still disputed (9)(10)(11).Although the roleofinflammation in the development of atherosclerosis and its complications is firmly established, its rolei nt he development of restenosisa fter PCI continuest ob eo fi nterest (29)(30)(31).I nc ontrast with several past studies ( 32,33), some recent studies have shown thatp reprocedural levels of inflammatorymarkers suchasC-reactive protein and interleukin-6 do not predict late coronaryangiographic restenosisafter electivestenting (30,34,35). The reason for this discrepancymay be the more intense use of statins and stents.…”

“…Several studieshaveshown asignificant association between plasma fibrinogen leveland subsequent CAD (5)(6)(7).F urthermore,e levatedf ibrinogenl evelsa fter coronary balloon angioplasty have beenreported as arisk factor forthe development of restenosis (4,8). However, there are little and conflicting clinical dataa vailablec oncerning the relationship between baseline fibrinogen levels and coronarye vents after coronarystenting (9)(10)(11).…”