Postangioplasty restenosis: Platelet activation and the coagulation-fibrinolysis system as possible factors in the pathogenesis of restenosis

Ishiwata, Sugao; Tukada, Toshiyasu; Nakanishi, Sigemoto; Nishiyama, Sinichiro; Seki, Akira

doi:10.1016/s0002-8703(97)70178-9

Cited by 92 publications

(60 citation statements)

References 30 publications

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“…Other studies conducted by Montalescot et al (1995) demonstrated that patients with restenosis showed elevations in several procoagulant factors such as PAI-1, tissue plasminogen activator antigen, fibrinogen, and factors VII and VIII. In addition, Ishiwata et al (1997) identified depression of the fibrinolytic response in patients who developed restenosis post-PCI as compared to those patients who did not develop restenosis. Homocysteine directly mediates the inhibition of fibrinolysis by preventing the cofactor activity of thrombomodulin and protein-C stimulation on endothelial cells (Hayashi et al 1992; Rodgers and Conn, 1990;Lenz and Sadler, 1991).…”

Section: Oxidative Stress and Restenosismentioning

confidence: 99%

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Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

et al. 2006

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Restenosis is one of the major adverse outcomes of Percutaneous CoronaryIntervention (PCI). Previous studies have shown conflicting reports for homocysteine as a predictor of restenosis following PCI. The conflicting reports may be due to oxidative factors (stimulation of polymorphonuclear leukocyte [PMNL]-induced reactive oxygen species generation, xanthine-xanthine oxidase, and arachidonic acid metabolism) other than homocysteine which could cause endothelial cell dysfunction leading to restenosis.Malondialdehyde (MDA), a lipid peroxidation product, is a marker for oxidative stress and is related to all oxidative factors. Therefore, it is possible that serum MDA may be a better predictor of restenosis than plasma homocysteine. The purpose of this study is to determine whether or not the pre-procedural serum MDA and plasma homocysteine levels are elevated in patients who develop restenosis post PCI.The study included fifty-one patients undergoing elective PCI who consented to participate in a protocol that was approved by the Ethics Committee of the University of Saskatchewan. Homocysteine and malondialdehyde were measured in the plasma and serum respectively. Blood samples were collected pre-procedural, 0 time, 8 hours, 24 hours, and 6 months post-procedure. Exercise tolerance tests were performed at two weeks, and six months post-procedure to determine if there was any evidence of restenosis.The results of the study showed that pre-procedural values of plasma homocysteine in the restenosis and non-restenosis groups were 10.37 ± 0.46 and 10.73 ± 0.49 respectively. These values were not significantly different (p=0.60) between the groups. The pre-procedural levels of plasma homocysteine were not significantly ii different (p=0.08) from the post-PCI values of those patients who did not develop restenosis at the 6-month time interval. However, the pre-procedural levels of plasma homocysteine were significantly different from the post-PCI values of those patients in the restenosis group at the 24hr (p=0.04) and 6-month (p=0.002) time intervals. In the restenosis group there was a significant increase (24%) after six months in the values of homocysteine from the pre-procedural levels. Thus, this indicates that restenosis is associated with higher post-PCI levels of homocysteine.The pre-procedural levels of serum MDA in the restenosis and non-restenosis groups were 0.124± 0.16 and 0.147± 0.02 respectively. There was no significant difference (p=0.60) between the two groups. There was also no significant difference The results suggest that pre-procedural levels of plasma homocysteine and serum MDA were not predictors of restenosis following PCI. However, the post-PCI sixmonth levels of both homocysteine and MDA are predictors of restenosis. Moreover, the post-PCI levels of MDA were better predictors of restenosis than the post-PCI levels of homocysteine because the increase in MDA levels were greater at six months than the rise in homocysteine levels at the same time interval.iii ACKNOWLEDGEMENTS

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Section: Oxidative Stress and Restenosismentioning

confidence: 99%

“…shown that post-PCI restenosis is correlated to an increase in procoagulant and depression of fibrinolytic activity Misra, 1974;Rowley and Halliwell, 1982;Ishiwata et al 1997). have demonstrated the attenuation of the genesis of cholesterol diet-induced atherosclerosis in rabbits treated with the antioxidant probucol.…”

Section: Oxidative Stress and Restenosismentioning

confidence: 99%

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

et al. 2006

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“…However, it remains largely unclear if addition of PAR1 antagonists would have an incremental benefit when added to current standard therapy in patients who underwent coronary revascularization procedures (PCI or CABG), which is of particular interest, as this patient population is at increased risk of rethrombosis, especially stent thrombosis (ST) and graft occlusion, mediated by persistent platelet activating mechanisms [2][3][4]. Hence, in the current meta-analysis, we evaluated the potential benefit and risk of addition of vorapaxar to standard in patients who underwent coronary revascularization with either PCI or CABG.…”

Section: Introductionmentioning

confidence: 99%

Role of Vorapaxar After Coronary Revascularization

Sharma

Lavie²,

Helft

et al. 2016

The American Journal of Cardiology

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“…[6][7][8] Percutaneous transluminal coronary angioplasty (PTCA) with or without stent implantation is an established revascularization procedure; however, restenosis rates still range between 30-60% 6 and 15-30%, 7 respectively Preprocedural identification of low-and high-risk patients who might benefit from additional procedures 6,8 would be desirable. However, the predictors of early [7][8][9][10] and late complications [11][12][13][14][15] have a low predictive value, [15][16][17][18] are available only after procedures, 9,14 or are not easily applicable in clinical practice. 10,12,13 Inconsistent and weak correlation with early complications following PTCA was reported for female gender, extreme age, diabetes, multivessel disease, lesion characteristics, and hemostatic variables.…”

Section: Introductionmentioning

confidence: 99%

“…However, the predictors of early [7][8][9][10] and late complications [11][12][13][14][15] have a low predictive value, [15][16][17][18] are available only after procedures, 9,14 or are not easily applicable in clinical practice. 10,12,13 Inconsistent and weak correlation with early complications following PTCA was reported for female gender, extreme age, diabetes, multivessel disease, lesion characteristics, and hemostatic variables. [6][7][8][9][10][11][12][13][14][15][16][17][18] This study was therefore undertaken to investigate the short-and long-term prognostic value of preprocedural serum levels of CRP in patients with AMI receiving PTCA/stenting.…”

Section: Introductionmentioning

confidence: 99%

The relation between preprocedural C‐reactive protein levels and early and late complications in patients with acute myocardial infarction undergoing interventional coronary angioplasty

Magadle

Hertz²,

Merlon³

et al. 2004

Clinical Cardiology

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SummaryBackground: Inflammation is an important feature of arteriosclerotic disease, and the vulnerability of coronary plaques in acute myocardial infarction (AMI) may be related to the levels of serum C-reactive proteins (CRP). While some risk factors for early and late complications have been suggested, an accurate and definitive preprocedural risk stratification of patients undergoing percutaneous transluminal coronary angioplasty (PTCA) is still lacking.Hypothesis: The study was undertaken to investigate whether early and late complications after PTCA could be predicted by evaluation of baseline serum CRP levels in patients with AMI.Methods: Levels of serum CRP were measured in a total of 230 patients with AMI undergoing PTCA and provisional stent. They were divided into two groups: Group 1 (n = 48) with elevated CRP levels (≥ 5 mg/l) and Group 2 (n = 182) with normal CRP levels (< 5 mg/l).Results: There were no significant differences in baseline clinical, angiographic, and procedural characteristics between the two groups. However, the incidence of in-hospital adverse coronary events (reinfarction, coronary reocclusion, target vessel revascularization, and death) and severe left ventricular dysfunction was significantly higher in Group 1 (18.3 vs. 6.1%,

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Postangioplasty restenosis: Platelet activation and the coagulation-fibrinolysis system as possible factors in the pathogenesis of restenosis

Cited by 92 publications

References 30 publications

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

Homocysteine and Malondialdehyde as Predictors of Restenosis Following Percutaneous Coronary Intervention

Role of Vorapaxar After Coronary Revascularization

The relation between preprocedural C‐reactive protein levels and early and late complications in patients with acute myocardial infarction undergoing interventional coronary angioplasty

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