Tissue factor and other hemostatic parameters in patients with advanced peripheral artery disease after endovascular revascularization - search for hemostatic factors which indicate restenosis.
BACKGROUND
In patients with peripheral artery disease (PAD) a hypercoagulable state and thromboembolic complications occur. Revascularization procedures increase this state, sometimes leading to restenosis. Restenosis following balloon angioplasty (PTA)and stent implantation is ≥ 50% of artery stenosis.


OBJECTIVE
To determine the concentration of tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-antithrombin (TAT) complexes, fibrinogen and D-dimers in the blood of patients with PAD after peripheral endovascular revascularization of the lower legs and in PAD patients with restenosis.


METHODS
The study included 150 patients with PAD, 90 men and 60 women, aged 44-88 (mean 65.5) years, after successful peripheral angioplasty (PTA) and/or with stenting. During the 6 months after the revascularization procedures, restenosis occurred in 27 patients. The reference group consisted of 53 healthy persons (44 men and 9 women, aged 20-56 years). Blood was drawn in the morning into 3.2% natrium citrate at a ratio of 9 : 1. The concentration of TF, TFPI, TAT complexes and D-dimers were measured in plasma with commercial tests using an enzyme immunoassay. Fibrinogen was determined with coagulometer.


RESULTS
In the plasma of patients with PAD after endovascular revascularization, the concentrations of TF, TAT complexes, fibrinogen and D-dimers were significantly higher compared to the reference group. During the six months of observation, 27 patients developed restenosis. The results of hemostatic factors in patients with restenosis were compared with the same patients before restenosis and the group of 123 PAD patients after endovascular revascularization. TF and fibrinogen levels in the 27 patients with restenosis were significantly higher than in the group of PAD patients before restenosis.


CONCLUSIONS
Statistically significantly higher levels of tissue factor (TF) and fibrinogen in PAD patients with new restenosis, compared to those without restenosis after endovascular revascularization, indicate they can participate in the formation of restenosis.
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Daniel
D
Kotschy
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Maria
M
Kotschy
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Paweł
P
Socha
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Leszek
L
Masłowski
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Justyna
J
Kwapisz
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Natalia
N
Żuk
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Joanna
J
Dubis
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Maciej
M
Karczewski
WROVASC Integrated Cardiovascular Center, Research and Development Center, Regional Specialized Hospital, Wrocław, Poland.
Wojciech
W
Witkiewicz
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000990:Antithrombin III; D015415:Biomarkers / Q000097:blood; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D005340:Fibrinogen / Q000378:metabolism*; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D006801:Humans; D007866:Leg / Q000098:blood supply / Q000473:pathology / Q000601:surgery; D008074:Lipoproteins / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D010447:Peptide Hydrolases / Q000097:blood; D058729:Peripheral Arterial Disease / Q000097:blood* / Q000473:pathology / Q000601:surgery; D013925:Thromboplastin / Q000378:metabolism*; D058017:Vascular Grafting
D015415:Biomarkers; D005338:Fibrin Fibrinogen Degradation Products; D008074:Lipoproteins; C046193:antithrombin III-protease complex; C036309:fibrin fragment D; C051928:lipoprotein-associated coagulation inhibitor; D000990:Antithrombin III; D005340:Fibrinogen; D013925:Thromboplastin; D010447:Peptide Hydrolases