High Plasma Heparin Cofactor II Activity Is Associated With Reduced Incidence of In-Stent Restenosis After Percutaneous Coronary Intervention

Abstract

The results demonstrate that HCII may have a hitherto unrecognized effect in inhibiting ISR. The effect of HCII may be mediated by inactivating thrombin in injured arteries, thereby inhibiting vascular smooth muscle cell migration and proliferation.

Does Heparin Cofactor II Modulate Atherosclerosis and Restenosis?

“…As a potent inhibitor of thrombin, HCII may help to down-regulate these processes. Takamori, 5 Aihara, 6 and their colleagues observed negative correlations between plasma HCII activity and the severity of restenosis and atherosclerosis in their patients. These important findings will provide the basis for future clinical and experimental work to determine if HCII is involved directly in arterial pathology or whether, like the storks of Copenhagen, it is there for some other reason.…”

“…In the first study, 5 134 consecutive patients with symptomatic coronary artery disease were treated with placement of conventional non-coated stents, followed by aspirin and ticlopidine for 1 month. Angiograms obtained during the procedure and 6 months later were evaluated in a blinded fashion to determine the degree of in-stent restenosis.…”

“…4 This work provides direct evidence that HCII can have antithrombotic activity in vivo and draws attention to the arterial system as a potential target of action of HCII. Two clinical studies 5,6 reported in Circulation suggest that HCII may help to protect people from in-stent restenosis or carotid artery atherosclerosis. …”

Plasma heparin cofactor II activity is inversely associated with left atrial volume and diastolic dysfunction in humans with cardiovascular risk factors

“…As HCII can counteract the actions of thrombin at injured vascular walls, we, and others, have investigated and confirmed the protective role of HCII against atherosclerosis in clinical examinations and studies using HCII-deficient mice. [9][10][11][12][13][14][15] As the development of vascular remodeling, including atherosclerosis, has been shown to be closely associated with cardiac remodeling in humans and experimental animal models, we hypothesized that HCII is involved in the process of not only atherosclerosis, but also cardiac remodeling. In order to clarify this issue, we investigated the relationships between plasma HCII activity and surrogate markers with respect to cardiac remodeling in elderly subjects with cardiovascular risk factors.…”

Heparin Cofactor II is an Independent Protective Factor against Peripheral Arterial Disease in Elderly Subjects with Cardiovascular Risk Factors

“…Thus, there is a possibility that HC can attenuate the progression of atherosclerosis by inhibiting thrombin action at the injured peripheral arteries. We previously reported an elderly woman with congenital HC deficiency who manifested multiple atherosclerotic disorders 25) , and we have reported the results of clinical studies showing that HC can reduce in-stent restenosis after percutaneous coronary intervention and reduce plaque formation in the carotid artery [26][27][28] . Moreover, we and Tollefsen's group have reported that prominently accelerated vascular remodeling, including atherosclerosis, was observed in HC -deficient mice compared to HC wild-type mice 29,30) .…”