Hm. Hoffmeister et al., LACK OF IMPACT OF ANGIOPLASTY ON THE TIME-COURSE OF ELEVATED COAGULATION AND FIBRINOLYSIS PARAMETERS IN UNSTABLE ANGINA-PECTORIS, Fibrinolysis & proteolysis, 11(4), 1997, pp. 221-227
Intracoronary thrombus formation is a common finding in patients with
unstable angina pectoris. In a prospective study in 21 patients with u
nstable angina pectoris without acute revascularization and in 14 pati
ents with acute revascularization (PTCA) treatment, we investigated mo
lecular markers of fibrinolysis and coagulation in order to assess whe
ther PTCA influences the alterations of the coagulation and fibrinolys
is in unstable angina during mid-term follow-up.Thrombin/antithrombin
III (TAT)-complexes as markers of the activated coagulation cascade, p
lasminogen activator inhibitor-1 (PAI-1), tissue-type plasminogen acti
vator (t-PA) and d-dimer levels as indicators of the fibrinolytic syst
em were measured serially up to 10 days after admission. Furthermore,
antithrombin III (AT III) and fibrinogen were determined. Data of the
patients with unstable angina pectoris were compared to 12 age-matched
healthy control persons. In patients with unstable angina pectoris, m
arked alterations of molecular markers of fibrinolysis and coagulation
were found. T-PA-antigen and PAI-1 were elevated in comparison to the
control group. There were no significant differences between the pati
ents with unstable angina pectoris who needed an acute PTCA and those
with only medical treatment either at admission or during follow-up. O
ur data indicate that in the patients with unstable angina pectoris, f
ibrinolysis and coagulation are disturbed. No significant differences
in time course between the patients with and without PTCA treatment ar
e found in this study, indicating that interventional procedures with
contrast media application and large intravascular artificial surfaces
do not affect the course of the alterations in coagulation and fibrin
olysis observed in acute coronary syndromes.