S. Yazdani et al., PERCUTANEOUS INTERVENTIONS ALTER THE HEMOSTATIC PROFILE OF PATIENTS WITH UNSTABLE VERSUS STABLE ANGINA, Journal of the American College of Cardiology, 30(5), 1997, pp. 1284-1287
Objectives. The objectives of this study were to define the hemostatic
profiles of patients with unstable angina compared with patients with
stable angina and to investigate the effect of percutaneous intervent
ions on the follow-up hemostatic profiles of these patients. Backgroun
d. Disturbances in hemostatic factors have been shown to be present in
various clinical syndromes involving coronary artery disease, However
, their role in stable angina versus unstable angina is less well defi
ned. Methods. We studied 61 patients with either stable or unstable an
gina undergoing percutaneous coronary interventions. Blood samples wer
e drawn immediately before the intervention and at 1-month follow-up.
Plasma levels of tissue-type plasminogen activator (t-PA), plasminogen
activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF) mere me
asured by enzyme-linked immunosorbent assays.Results. Patients with un
stable angina had significantly higher t-PA levels (mean [+/-SE] 23.7
+/- 3.4 vs. 14.3 +/- 1.4 ng/ml, respectively, p = 0.02) and vWF antige
n concentrations (2,231 +/- 157 vs. 1,792 +/- 108 mU/ml, respectively,
p = 0.03) than patients with stable angina. No statistically signific
ant differences were observed in the PAI-1 levels between the two grou
ps (27.9 +/- 5.5 vs. 21.4 +/- 2.5 ng/ml, respectively, p = 0.25). At 1
-month follow-up, there mere no longer any significant differences in
the t-PA or vWF levels between the two groups (15.7 +/- 1.2 vs. 13.6 /- 0.6 ng/ml, p = 0.13; 1,962 +/- 170 vs. 1,809 +/- 88 mU/ml, p = 0.39
, respectively). There were no significant differences between the hem
ostatic profiles of patients undergoing percutaneous transluminal coro
nary angioplasty or coronary stenting initially and at 1-month follow-
up. Conclusions. These data suggest that elevated plasma levels of t-P
A and vWF may correlate with instability of atheromatous plaques, and
that their decrease after coronary interventions may reflect plaque re
endothelialization and stabilization. (C) 1997 by the American College
of Cardiology.