Changes of plasma hemostatic markers during percutaneous transluminal coronary angioplasty in patients with chronic coronary artery disease

Changes of hemostatic parameters during percutaneous transluminal coronary angioplasty (PTCA) in 75 patients with chronic coronary artery disease were evaluated. Plasma levels of D-dimer, soluble fibrin monomer, plasmin-alpha 2 antiplasmin inhibitor complex, and tissue factor (TF) were significantly increased in all patients with chronic coronary artery disease. The activi ty of antithrombin and protein C and the levels of protein C antigen were s ignificantly decreased 1 hr after PTCA, but they returned to normal range 1 day after PTCA. There was no significant difference in the level of plasma APC-PCI complex before and 1 hr after PTCA. The plasma levels of D-dimer, soluble fibrin monomer, thrombomodulin, if and PPIC were significantly decr eased 1 hr, and the plasma levels of plasmin-alpha 2 antiplasmin inhibitor complex 1 day after PTCA. These findings suggest that the decrease of prote in C and antithrombin resulted in activation of the coagulation system. One hour after PTCA, the plasma levels of (total-free) TF pathway inhibitor (T FPI) were significantly decreased, but the plasma levels of total and free- TFPI were significantly increased, suggesting that comsumption of (total-fr ee) TFPI occurs during PTCA. Overall, these findings suggest that the hyper coagulable state improves during PTCA and that transient decrease of antith rombin, protein C, (total-free) TFPI or plasmin-alpha 2 antiplasmin inhibit or complex may cause restenosis of coronary artery. (C) 1999 Wiley-Liss,Inc .