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Plasminogen activator inhibitor‐1 predicts coronary in‐stent restenosis of drug‐eluting stents
Author(s) -
KATSAROS K. M.,
SPEIDL W. S.,
KASTL S. P.,
ZORN G.,
HUBER K.,
MAURER G.,
GLOGAR D.,
WOJTA J.,
CHRIST G.
Publication year - 2008
Publication title -
journal of thrombosis and haemostasis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.947
H-Index - 178
eISSN - 1538-7836
pISSN - 1538-7933
DOI - 10.1111/j.1538-7836.2007.02884.x
Subject(s) - conventional pci , restenosis , medicine , percutaneous coronary intervention , plasminogen activator inhibitor 1 , cardiology , plasminogen activator , stent , drug eluting stent , lumen (anatomy) , myocardial infarction
Summary. 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.