ANTIPHOSPHOLIPID ANTIBODIES - A NEW RISK FACTOR FOR RESTENOSIS AFTER PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY

Antiphospholipid antibodies (aPL) have been found to be associated wit h arterial and venous thrombosis. Percutaneous transluminal coronary a ngioplasty (PTCA) is an established therapy for ischaemic heart diseas e (IHD), which is still affected by restenosis at a rate of 20-30%. Th is study was aimed at investigating the possible role of aPL in resten osis after PTCA. In sir;ty consecutive II-ID patients, aPL (lupus anti coagulant -LA- and anticardiolipin antibodies -aCL) and markers of hae mostatic activation were investigated before PTCA, and patients were f ollowed up for restenosis. No infections, autoimmune disease or treatm ent by drugs that may alter aPL levels occurred in any of the patients . aPL wen found in 15/60 patients: aCL in 7/60, LA in 5/60 and aCL and LA in 3/60. No statistically significant difference was found between aPL negative and aPL positive patients in pre PTCA plasma levels of p rothrombin activation fragment (F1+2) 1.4 nmol/l (0.3-5.71) vs 1.4 nmo l/l (0.9-4.0), thrombin-antithrombin complex (TAT) 4.0 mu g/l (1.1-34. 2) vs 5.2 mu g/l (2.1-60.0), D-dimer (DD) 25 ng/ml (2-515) vs 44 ng/ml (2-160) or plasminogen activator inhibitor activity (PAI) 4.8 IU/ml ( 2.5-36.4) vs 1.4 IU/ml (2.5-13.4;). Restenosis was observed in 13/60 p atients (7/45-15% - aPL negative and 6/15-40% - aPL positive patients) who underwent angiographic tests after PTCA because of recurring angi na or positive exercise test. Restenosis occurred after 2.2 months (0. 5-3) in aPL positive patients and after 3.5 months (1-12.8) in aPL neg ative.