title: Impaired fibrinolytic capacity and tissue plasminogen activator release in patients with restenosis after percutaneous transluminal coronary angioplasty (PTCA).
abstract: To assess the role of the fibrinolytic system in the pathogenesis of restenosis after percutaneous transluminal coronary angioplasty (PTCA), we determined the components of this system in a retrospective study, including 16 patients with restenosis (gr. A) and 19 patients with long-term success (gr. B). In both groups at baseline fibrinolytic activity (FA) is unchanged, whereas tissue plasminogen activator antigen (tPA-Ag) is significantly increased (gr. A: 147.0%; gr. B: 139.8%; p less than 0.01). Fibrinolytic capacity (FC) and tPA-Ag release are significantly reduced in the restenosis group (FC: 46.5%, p less than 0.05; tPA-Ag release: 48.3%, p less than 0.01) compared to normal controls as well as to gr. B (FC: 84.3%, p less than 0.05; tPA-Ag release: 79.0%, p less than 0.05). Relating to the contact activation system, F XII (79.5%, p less than 0.05) is significantly, and F XI (82.3%) is clearly reduced in gr. A. Protein C (PC) is significantly elevated in gr. B (117.5%, p less than 0.05). There is a negative correlation between plasminogen activator inhibitor (PAI 1) and HDL-cholesterol (r = 0.37, p less than 0.05). It appears, that there is a typical pattern of defective fibrinolysis in patients with restenosis after PTCA and that this might be a pathogenetic factor in the development of restenosis.
authors.affiliation: I. Medizinische Klinik, Klinikum Mannheim, FRG.
authors.forename: W
authors.initials: W
authors.lastname: Kirschstein
authors.forename: S
authors.initials: S
authors.lastname: Simianer
authors.forename: C E
authors.initials: CE
authors.lastname: Dempfle
authors.forename: H
authors.initials: H
authors.lastname: Keller
authors.forename: B
authors.initials: B
authors.lastname: Stegaru
authors.forename: P
authors.initials: P
authors.lastname: Rentrop
authors.forename: D L
authors.initials: DL
authors.lastname: Heene
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D003327:Coronary Disease / Q000097:blood* / Q000628:therapy; D005260:Female; D005342:Fibrinolysis; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D010959:Tissue Plasminogen Activator / Q000097:blood*
chemical_list: D010959:Tissue Plasminogen Activator