title: A history of late and very late stent thrombosis is not associated with increased activation of the contact system, a case control study.
abstract: BACKGROUND
  The pathophysiological pathways resulting in Late Stent Thrombosis (LST) remain uncertain. Findings from animal studies indicate a role of the intrinsic coagulation pathway in arterial thrombus formation, while clinical studies support an association with ischemic cardiovascular disease. It is currently unknown whether differences in the state of the contact system might contribute to the risk of LST or Very Late Stent Thrombosis (VLST). We assessed the relation between levels of several components involved in the contact system and a history of LST and VLST, termed (V)LST in a cohort of 20 patients as compared to a matched control group treated with PCI.
  
  
  RESULTS
  Activated factor XII (FXIIa), FXII zymogen (FXII), FXIIa-C1-esterase inhibitor (C1-inhibitor), Kallikrein-C1-inhibitor, FXIa-C1-inhibitor and FXIa-alpha1-antitrypsin (AT-inhibitor) complexes were measured by Enzyme-linked immunosorbent assy (ELISA) methodology.Cases and controls showed similar distributions in sex, age, baseline medications and stent type. Patients with a history of (V)LST had a significantly greater stent burden and a higher number of previous myocardial infarctions than the control patients.There were no significant between-group differences in the plasma levels of the components of the contact system.
  
  
  CONCLUSIONS
  In a cohort of patients with a history of (V)LST, we did not observe differences in the activation state of the intrinsic coagulation system as compared to patients with a history of percutaneous coronary intervention without stent thrombosis.
authors.affiliation: Institute of Medicine, University of Bergen, Bergen, Norway. povo@sus.no.
authors.forename: Volker
authors.initials: V
authors.lastname: Pönitz
authors.forename: José W
authors.initials: JW
authors.lastname: Govers-Riemslag
authors.forename: Hugo
authors.initials: H
authors.lastname: Ten Cate
authors.forename: Rene
authors.initials: R
authors.lastname: van Oerle
authors.forename: Trygve
authors.initials: T
authors.lastname: Brügger-Andersen
authors.forename: Heidi
authors.initials: H
authors.lastname: Grundt
authors.forename: Patrycja
authors.initials: P
authors.lastname: Næsgaard
authors.forename: David
authors.initials: D
authors.lastname: Pritchard
authors.forename: Alf I
authors.initials: AI
authors.lastname: Larsen
authors.forename: Dennis W
authors.initials: DW
authors.lastname: Nilsen
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