Plasma urokinase antigen and plasminogen activator inhibitor-1 antigen levels predict angiographic coronary restenosis

Article

关键词: CELL-MIGRATION;    BALLOON ANGIOPLASTY;    NEOINTIMA FORMATION;    ANGINA-PECTORIS;    RECEPTOR;    VITRONECTIN;    ARTERY;    ATHERECTOMY;    ADHESION;    BINDING;   

DOI  :  10.1161/01.CIR.100.15.1616

来源: SCIE

【 摘 要 】

Background-The fibrinolytic system is intimately involved in several processes that contribute to restenosis, including clot dissolution. cell migration, and tissue remodeling. However, the role of the individual activators (urokinase [uPA] and tissue plasminogen [tPA] activators) and inhibitors (plasminogen activator inhibitor [PAI-1]) of the fibrinolytic system in maintaining patency after coronary artery angioplasty and stenting is unclear. Methods and Results-We prospectively studied 159 patients with stable angina who underwent successful elective angioplasty (n=110) or stenting (n=49) of de novo native coronary artery lesions. Plasma samples were drawn at baseline (before angioplasty) and serially after angioplasty (immediately afterward and 6 hours, 24 hours, 3 days, 7 days, month. 3 months. and 6 months afterward). Antigen and activity assays were performed for uPA, tPA, and PAI-1 Follow-up quantitative coronary angiography was performed in 92% of eligible patients Thr overall angiographic restenosis rate (diameter stenosis >50%) was 31% (37% in PTCA patients, 17% in stented patients). At all time periods, including baseline, uPA antigen levels were significantly higher and PAI-1 antigen levels were significantly lower in patients with restenosis. Restenosis rates for patients in the upper tertile of baseline uPA antigen levels were 2-fold higher than for those in the lower 2 tertiles (46% versus 24% and 22%, respectively; P<0.004). In a stepwise regression multivariate analysis, obstruction diameter after the procedure and uPA antigen were significant predictors of follow-up diameter stenosis. Conclusions-Plasma uPA antigen levels and PAI-1 antigen levels identify patients at increased risk fur restenosis after percutaneous coronary revascularization.

【 授权许可】

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