MARKERS OF HEMOSTATIC ACTIVATION IN AFFECTED CORONARY-ARTERIES DURINGANGIOPLASTY

To characterize the extent of early activation of the hemostatic syste m following angioplasty, we obtained blood samples from the involved c oronary artery of 11 stable angina patients during the procedure and m easured sensitive markers of thrombin formation (fibrinopeptide A, pro thrombin fragment 1.2, and soluble fibrin) and of platelet activation (beta-thromboglobulin). Levels of hemostatic markers in venous blood o btained from 14 young individuals with low pretest probability for cor onary artery disease were not significantly different from levels in v enous blood or intracoronary samples obtained prior to angioplasty. Al so, there was no translesional (proximal and distal to the lesion) gra dient in any of the hemostatic markers before or after angioplasty in samples obtained between 18 and 21 min from the onset of the first bal loon inflation. Furthermore, no significant difference was noted betwe en angioplasty and postangioplasty intracoronary concentrations. We co nclude that intracoronary hemostatic activation does not occur in the majority of patients during and immediately following coronary angiopl asty when high doses of heparin and aspirin are administered.