Influence of haematological parameters before coronary angioplasty on subsequent restenosis.
OBJECTIVE
Restenosis is the major limitation of coronary interventions occurring in nearly a third of the patients undergoing percutaneous transluminal coronary angioplasty (PTCA) with no single, definite predictor demonstrated in an individual patient. Platelets are known to play an important role in the pathogenesis of subsequent restenosis.


RESULTS
In a prospective study, follow-up coronary angiographies were performed in 102 consecutive patients with stable angina who underwent a successful PTCA for single-vessel coronary artery disease. Demographics, baseline lipid profiles (total cholesterol, HDL- and LDL-cholesterol, triglycerides) and haematological parameters (red cell, white cell and platelet counts, haemoglobin concentration, haematocrite %, mean platelet volume, platelet mass and fibrinogen levels) were compared between patients with and without restenosis. In the restenosis group, mean platelet volume (8.82 +/- 0.78 fl vs. 8.13 +/- 0.64 fl, p < 0.001), white cell count (8673 +/- 322 x 10(3)/microl vs. 7513 +/- 232 x 10(3)/microl, p < 0.01) and fibrinogen level (4.2 +/- 1.4 g/l vs 3.6 +/- 1.1 g/l) were significantly higher. The relative odds for developing angiographically defined restenosis were 2.49 times greater in diabetics (p = 0.11) and 2.54 times greater in men (p = 0.13). It is 1.43 times greater in patients with higher fibrinogen levels (p = 0.16). But, the relative odds for developing restenosis were 10.43 times greater in patients with larger pre-procedural mean platelet volumes (p < 0.01).


CONCLUSIONS
There was a positive correlation between mean platelets volume and loss in luminal diameter between post-angioplasty and follow-up angiographies (r = +2.345, p = 0.01). There was no association between restenosis and haemoglobin, haematocrit, red cell count, white cell count, platelet count, platelet mass and plasma fibrinogen level. The development of restenosis after successful coronary angioplasty may be mainly influenced by the platelet size.
Avci
Ahmet
A
Turkiye Yuksek Ihtisas Hospital, Department of Cardiology, Ankara, Turkey.
Boyaci
Ayca
A
Cağli
Kerim
K
Cosgun
Ayhan
A
Gokce
Veli
V
Duru
Erdal
E
Korkmaz
Sule
S
D000787:Angina Pectoris / Q000209:etiology; D015906:Angioplasty, Balloon, Coronary; D001792:Blood Platelets / Q000502:physiology*; D002908:Chronic Disease; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000000981:diagnostic imaging; D023903:Coronary Restenosis / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D018570:Risk Assessment