Elevated whole-blood tissue factor procoagulant activity as a marker of restenosis after percutaneous transluminal coronary angioplasty and stent implantation
Elevated whole-blood tissue factor procoagulant activity as a marker of restenosis after percutaneous transluminal coronary angioplasty and stent implantation
复制标题
DOI：
10.1161/01.cir.0000091082.75419.9f
复制
发表时间：
2003-09-30
期刊：
影响因子：
37.8
通讯作者：
Key, NS
中科院分区：
文献类型：
--
作者：
Tutar, E;Ozcan, M;Key, NS
背景--实验数据表明组织因子（TF）可诱导动脉损伤后新生内膜增生.在这项研究中，我们研究了循环中TF水平升高有助于经皮腔内冠状动脉成形术（PTCA）或支架植入术后再狭窄的发展的假设。方法和结果-全血TF促凝活性（TF-PCA）使用先前描述的测定法测量，61例稳定型心绞痛患者行PTCA（n = 20）或支架置入术（n = 41），术后24 h进行上述指标的测定。介入术后4 ~ 6个月行冠状动脉造影，管腔狭窄≥ 50%定义为再狭窄。全血TF-PCA水平与细胞内单核细胞肿瘤坏死因子-α表达（这些细胞活化的标志物）无关。在随后发生或未发生再狭窄的患者中，比较了干预后全血TF-PCA的基线水平和时程。全血TF-PCA水平在两种干预后24小时内均无显著变化。然而，在这两个PTCA和支架组，初始TF-PCA是显着较高的患者随后发展再狭窄（P = 0.018和0.039相比，那些没有发展再狭窄的PTCA和支架组，分别）。结论-较高的基线值的全血TF-PCA可能是一个预测再狭窄后，PTCA和支架植入术。
Background - Experimental data suggest that tissue factor (TF) may induce neointimal hyperplasia after arterial injury. In this study, we investigated the hypothesis that elevated levels of TF in the circulation contribute to the development of restenosis after percutaneous transluminal coronary angioplasty ( PTCA) or stent implantation.Methods and Results - Whole-blood TF procoagulant activity (TF-PCA) was measured using a previously described assay before, at 3 hours after, and at 24 hours after the intervention in 61 patients with stable angina undergoing PTCA (n = 20) or stent implantation (n = 41). Coronary angiography was performed 4 to 6 months after the intervention, and luminal narrowing greater than or equal to 50% was defined as restenosis. Whole-blood TF-PCA levels did not correlate with intracellular monocyte tumor necrosis factor-alpha expression, a marker of activation of these cells. Baseline levels and time course of whole-blood TF-PCA after the intervention were compared in patients who did or did not subsequently develop restenosis. Whole-blood TF-PCA levels did not change significantly in the 24 hours after either intervention. However, in both the PTCA and stent groups, initial TF-PCA was significantly higher in patients who subsequently developed restenosis ( P = 0.018 and 0.039 compared with those who did not develop restenosis for PTCA and stent groups, respectively).Conclusions - Higher baseline values of whole-blood TF-PCA may be a predictor of restenosis after PTCA and stent implantation.