Plasma fibrinogen as a risk factor for restenosis after percutaneous transluminal renal angioplasty in patients with atherosclerotic renal artery stenosis

Background In contrast to those for coronary restenosis, the data regarding the risk factors for renal restenosis are limited. Objective To evaluate potential humoral risk factors for restenosis after p ercutaneous transluminal renal angioplasty (PTRA), Methods We studied 27 patients aged 54 +/- 10 years with atherosclerotic re nal artery stenosis in a 1-year prospective follow-up. Restenosis (confirme d by angiography) occurred in eight patients 1-6 months after PTRA. We dete cted no Doppler ultrasound evidence of restenosis in 19 patients throughout 1 year. Blood studies were done before PTRA for all patients, at the time of diagnosis of restenosis and, for those without restenosis, after 1 year. including determinations of fibrinogen, lipids, platelets and leukocytes. Results The mean level of fibrinogen in patients who experienced restenosis was higher than that in those who did not (450 +/- 150 mg% versus 337 +/- 57 mg%, P < 0.01) and remained unchanged for both groups during follow-up. The other parameters did not differ between the groups before PTRA and did not change over time, with the exception of platelet count in patients who did not experience restenosis, which had decreased from 253 +/- 93 G/l to 2 00 +/- 63 G/l (P < 0.01) 1 year after PTRA. The logistic multiple regressio n analysis disclosed that an increment of fibrinogen level by 100 mg% was l inked with an odds ratio for restenosis of 3.2 (95% confidence interval 1.1 -9.8), Conclusions Restenosis was associated With higher than normal levels of fib rinogen before PTRA, A high plasma fibrinogen level might Flay a role in th e development of restenosis after PTRA, (C) 1999 Lippincott Williams & Wilk ins.