Plasminogen activator inhibitor-1 predicts coronary in-stent restenosis of drug-eluting stents.
BACKGROUND
We tested the hypothesis that plasma levels of plasminogen activator inhibitor-1 (PAI-1) are influenced by percutaneous coronary intervention (PCI) with the implantation of drug eluting stents (DES) and are able to predict the occurrence of in-stent restenosis (ISR).


RESULTS
PAI-1 active antigen plasma levels were determined in 75 patients before and 24 h after PCI with DES implantation. Patients with ISR after six to eight months (16%) showed significantly lower PAI-1 plasma levels before PCI (ISR, 11.7 +/- 8.1 ng mL(-1); non-ISR, 22.8 +/- 18.8 ng mL(-1); P <0.05). PAI-1 levels in the lowest tertile were associated with a 9.5-fold increased risk of ISR, independent of clinical risk factors, angiographic or procedural characteristics, compared to the highest tertile (P < 0.05). The induced change of PAI-1 active antigen 24 h after PCI was significantly higher in patients with ISR (ISR, +5.6 +/- 8.0 ng mL(-1); non-ISR, -3.2 +/- 12.1 ng mL(-1); P < 0.05) with positive correlation to late lumen loss (r = 0.30; P < 0.05).


CONCLUSIONS
ISR after DES implantation is significantly related to plasma levels of PAI-1 active antigen before and after PCI. If confirmed by larger multicenter studies, the determination of PAI-1 plasma levels might be clinically helpful in the identification of patients at high risk of developing of ISR, even after DES implantation.
Katsaros
K M
KM
Department of Cardiology, Medical University of Vienna, Vienna, Austria.
Speidl
W S
WS
Kastl
S P
SP
Zorn
G
G
Huber
K
K
Maurer
G
G
Glogar
D
D
Wojta
J
J
Christ
G
G
D000368:Aged; D000792:Angiography / Q000379:methods; D000077144:Clopidogrel; D023903:Coronary Restenosis / Q000097:blood* / Q000517:prevention & control*; D054855:Drug-Eluting Stents / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood*; D012044:Regression Analysis; D012307:Risk Factors; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000494:pharmacology; D013997:Time Factors; D010959:Tissue Plasminogen Activator / Q000097:blood; D016896:Treatment Outcome
D017395:Plasminogen Activator Inhibitor 1; D000077144:Clopidogrel; D010959:Tissue Plasminogen Activator; D013988:Ticlopidine