IMPAIRED FIBRINOLYSIS EARLY AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY IS ASSOCIATED WITH RESTENOSIS

This study examined the role of fibrinolytic components in the process of restenosis after percutaneous transluminal coronary angioplasty (P TCA). Seventy-two patients with single-vessel disease who underwent su ccessful PTCA were prospectively selected. Tissue plasminogen activato r (TPA), free plasminogen activator inhibitor-1 (free PAI-1), TPA/PAI- 1 complex, and total PAI-1 antigen levels were measured before, at 1 w eek after, and at 3 months after PTCA. Six months after PTCA, the stud y patients were divided into two groups: 41 patients without restenosi s and 31 patients with restenosis. There were no significant differenc es with regard to sex, age, coronary risk factors, or morphologic chan ges in the target lesions between the two groups. There were no signif icant differences in plasma TPA, TPA/PAI-1 complex, or total PAI-1 lev els at each sampling period, or in the time courses between the two gr oups, except for total PAI-1 levels at 1 week after PTCA. Although no significant differences in free PAI-1 levels before PTCA were observed , free PAI-1 levels after PTCA in the patients with restenosis were si gnificantly higher than those in the patients without restenosis. In a ddition, each group had a significant change in the time course of fre e PAI-1 levels. The results suggest that impaired fibrinolysis early a fter PTCA might affect the repair process of vascular injury, which le ads to restenosis, and also that serial determination of free PAI-1 le vels could help predict restenosis.