Thrombin activation and late restenosis after percutaneous transluminal coronary angioplasty.
BACKGROUND
Mechanisms of restenosis after percutaneous transluminal coronary angioplasty (PTCA) have not been defined yet. Experimental studies have shown that thrombin, by stimulating platelet growth factor secretion and smooth muscle cell proliferation, can play a major role.


RESULTS
In 34 patients with single-vessel coronary disease undergoing PTCA, thrombin activity was evaluated through serial fibrinopeptide A (FPA) plasma determinations. Samples were performed before PTCA, immediately after and 24 hours, 72 hours, and 6 months later. Patients were grouped according to the development (group 1, n = 13) or nondevelopment (group 2, n = 21 ) of restenosis at a 6-month angiographic control. No difference in the two groups was found concerning baseline FPA values. In patients in group 1, soon after PTCA higher FPA levels (27.3 +/- 13.7 ng/ml) than those in group 2 (9.2 +/- 5.6 ng/ml; p < 0.05 vs pre-PTCA, and p < 0.01 between the two groups) were observed. No differences in FPA levels were detected at the other steps between the two groups.


CONCLUSIONS
Our data suggest that thrombin plays a role in the process of restenosis after PTCA; acute FPA response to the procedure seems to have a predictive value.
Salvioni
A
A
Istituto di Cardiologia dell'Università degli Studi, Centro di Studio per le Ricerche Cardiovascolari del Consiglio Nazionale delle Ricerche, Fondazione Monzino, IRCCS, Milan, Italy.
Galli
S
S
Marenzi
G
G
Lauri
G
G
Perego
G B
GB
Assanelli
E
E
Guazzi
M D
MD
D000368:Aged; D000789:Angina, Unstable / Q000503:physiopathology / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy*; D005260:Female; D005344:Fibrinopeptide A / Q000032:analysis; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000628:therapy; D012008:Recurrence; D013917:Thrombin / Q000502:physiology*; D013997:Time Factors
D005344:Fibrinopeptide A; D013917:Thrombin