Assessment of coagulation and platelet activation in coronary sinus blood induced by transcatheter coronary intervention for narrowing of the left anterior descending coronary artery
O. Mizuno et al., Assessment of coagulation and platelet activation in coronary sinus blood induced by transcatheter coronary intervention for narrowing of the left anterior descending coronary artery, AM J CARD, 85(2), 2000, pp. 154-160
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Influences of recently developed methods for coronary intervention on hemos
tasis in the coronary circulation are unclear. The objective of this study
was to investigate changes in coagulation and platelet activation in the co
ronary circulation induced by percutaneous transluminal coronary angioplast
y (PTCA). We studied 35 patients with coronary heart disease who underwent
elective PTCA to isolated stenotic narrowing of left coronary arteries. Sev
en patients received only PTCA, 12 underwent percutaneous transluminal rota
tional atherectomy (PTRA), and 16 underwent stent implantation. Blood sampl
es were drawn from the coronary sinus immediately before and after as well
as 4 and 24 hours after PTCA. plasma revels of tissue factor (TF), thrombin
-antithrombin III complex, plasminogen activator inhibitor (PAI)-1, tissue
plasminogen activator (t-PA), beta-thromboglobulin, and platelet factor 4 w
ere measured by enzyme-linked immunosorbent assay. In all patients, levels
in the coronary sinus blood showed significant increases 4 and 24 hours aft
er PTCA and thrombin-antithrombin III complex levels showed significant inc
reases 24 hours after PTCA. PAI-I showed significant increases 24 hours aft
er PTCA and t-PA showed significant increases 4 and 24 hours after PTCA. Ch
anges in levels of these markers by PTCA were similar among the 3 groups. I
n PTRA, levels of beta-thromboglobulin and platelet factor 4, markers of pl
atelet activation, increased immediately after the procedure and returned t
o baseline levels after 4 hours. PTCA induced increases in blood coagulatio
n and fibrinolysis in the coronary circulation. PTRA caused a marked but tr
ansient activation of platelets. These changes may contribute to acute comp
lications during the procedure. (C) 2000 by Excerpta Medica, Inc.