title: Long-term serial changes in platelet activation indices following sirolimus elution and bare metal stent implantation in patients with stable coronary artery disease.
abstract: BACKGROUND
  Platelet activation is crucial in the development of stent thrombosis following percutaneous coronary intervention (PCI). We carried out a long-term assessment of multiple factors implicated in the thrombotic process and monitored markers of platelet activation after the implantation of sirolimus-eluting stents (SES) in patients with stable coronary artery disease (CAD). Additionally, we compared these findings with those after bare-metal stent (BMS) implantation.
  
  
  METHODS
  A cohort of 47 consecutive patients, aged <70 years, with severe stenosis (>70% narrowing of the lumen) of one major epicardial coronary artery and stable CAD underwent successful elective PCI. Patients were randomly allocated to SES (n = 25) or BMS (n = 22). Venous blood was obtained 24 hours before and 24 hours, 48 hours, 1 month, and 6 months after PCI for measurements of plasma levels of sP-selectin, von Willebrand Factor (vWF), fibrinogen, d-dimer, sCD40, factor VIII, b-thromboglobulin (b-TG) and platelet factor 4 (PF-4).
  
  
  RESULTS
  There were no significant differences between the two groups in levels of fibrinogen or d-dimers in peripheral blood. However, we observed a significant kinetic effect (p<0.001) and stent-effect (p<0.015) on vWF levels and a significant kinetic effect (p = 0.012) on factor VIII, sP-selectin (p = 0.04), b-TG (p<0.001), and PF4 (p = 0.016). A trend towards a significant stent effect on sCD40 was also detected (p = 0.06).
  
  
  CONCLUSIONS
  SES and BMS did not show significant differences in relationship to markers of platelet activation and coagulation in patients with stable CAD. Although some markers showed an increase after stent implantation, they returned to the initial levels 6 months later.
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece. Electronic address: maryemarke@yahoo.gr.
authors.forename: Maria
authors.initials: M
authors.lastname: Marketou
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: George E
authors.initials: GE
authors.lastname: Kochiadakis
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: Aikaterini
authors.initials: A
authors.lastname: Giaouzaki
authors.affiliation: Regional Blood Bank Centre, Venizelion Hospital, Crete, Greece.
authors.forename: Katerini
authors.initials: K
authors.lastname: Sfiridaki
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: Stelios
authors.initials: S
authors.lastname: Petousis
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: Fragiskos
authors.initials: F
authors.lastname: Maragoudakis
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Roufas
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Vougia
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: John
authors.initials: J
authors.lastname: Logakis
authors.affiliation: Division of Biostatistics, School of Medicine, University of Crete, Greece.
authors.forename: Gregory
authors.initials: G
authors.lastname: Chlouverakis
authors.affiliation: Cardiology Dept, Heraklion University Hospital, Crete, Greece.
authors.forename: Panos E
authors.initials: PE
authors.lastname: Vardas
mesh_terms: D000368:Aged; D003324:Coronary Artery Disease; D023903:Coronary Restenosis / Q000209:etiology / Q000517:prevention & control; D054855:Drug-Eluting Stents / Q000009:adverse effects / Q000592:standards*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects / Q000295:instrumentation*; D015539:Platelet Activation / Q000502:physiology*; D020123:Sirolimus / Q000008:administration & dosage* / Q000009:adverse effects; D015607:Stents / Q000009:adverse effects / Q000592:standards*; D013927:Thrombosis / Q000473:pathology / Q000517:prevention & control; D016896:Treatment Outcome
chemical_list: D005338:Fibrin Fibrinogen Degradation Products; D005343:Fibrinolytic Agents; C036309:fibrin fragment D; D020123:Sirolimus
keywords: Coronary artery disease; Platelet activation; Stents