Thrombin-activatable fibrinolysis inhibitor (TAFI): a novel predictor of angiographic coronary restenosis.
The fibrinolytic system is closely related to several processes that are involved in restenosis. We previously showed that low PAI-1 plasma levels predicted restenosis. Recently, a different fibrinolytic inhibitor, TAFI, has been described. The aims of this study were to evaluate the relationship between pre-procedural plasma levels of TAFI and late angiographic restenosis and the interaction between TAFI and PAI-1.We prospectively studied 159 patients with stable angina who underwent successful elective angioplasty or stenting of de novo native coronary artery lesions. TAFI and PAI-1 antigen levels were measured in plasma samples drawn before the procedure. Follow-up coronary angiography was performed in 92% of patients. There was a significant correlation between pre-procedural TAFI levels and 6-month % diameter stenosis (DS) (r = 0.21; p = 0.013). The overall angiographic restenosis rate (DS>50%) was 31%. Pre-procedural TAFI levels were significantly higher in patients with restenosis (108 +/- 33% versus 94+/-30%, p = 0.011). Restenosis rates for patients in the upper tertile of TAFI levels were 2-fold higher than for those in the lowest tertile (45% versus 22%; p = 0.016). A combination of high TAFI and low PAI-1 levels identified patients at the highest risk of restenosis (53%) compared to 14% in patients with low TAFI and high PAI-1 levels; p = 0.027. In conclusion, pre-procedural plasma TAFI antigen levels identify patients at increased risk for restenosis after PCI.
Lau
Herbert K
HK
Division of Hematology and Oncology, St. Michael's Hospital, University of Toronto, Ontario, Canada M5B 1W8.
Segev
Amit
A
Hegele
Robert A
RA
Sparkes
John D
JD
Teitel
Jerome M
JM
Chisholm
Robert J
RJ
Strauss
Bradley H
BH
D000368:Aged; D000787:Angina Pectoris / Q000097:blood / Q000150:complications / Q000601:surgery; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D025901:Carboxypeptidase B2 / Q000097:blood*; D023903:Coronary Restenosis / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D015607:Stents
D017395:Plasminogen Activator Inhibitor 1; D025901:Carboxypeptidase B2