Mk. Warshofsky et al., Elevated plasma tissue plasminogen activator and anti-THP-1 antibodies areindependently associated with decreased graft survival in cardiac transplant recipients, AM J CARD, 88(1), 2001, pp. 30-34
Citations number
25
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Hemostatic and immunologic factors have been implicated in future cardiac e
vents in patients with coronary artery disease. The role of these factors a
nd their interaction is less established in cardiac transplant recipients.
We sought to characterize the role of these factors in these patients. Card
iac transplant patients who presented for surveillance coronary angiography
and/or endomyocardial biopsy were eligible for enrollment. Ninety-nine con
secutive patients were enrolled. Plasma levels of tissue-type plasminogen a
ctivator (t-PA), plasminogen activator inhibitor-1, von Willebrand factor,
fibrin D-dimer, and anti-t-PA antibody were determined by enzyme-linked imm
unosorbent assays. Anti-THP 1 cell antibodies directed against a monocytic
leukemia cell line were detected by incubating patient plasma with THP-1 ce
lls. Bound antibody was detected using goat peroxidase-labeled immunoglobul
in C directed against human immunoglobulins. Lipids were measured by enzyma
tic methods. Multivariate analysis identified the presence of anti-THP-1 ce
ll antibodies (risk ratio 4.41, p = 0.002), t-PA antigen (risk ratio;1.10,
p = 0.033), donor age 20 to 26 years (risk ratio 8.83, p = 0.042), and dono
r age > 36 years (risk ratio 15.53, p = 0.009) as predictors of allograft f
ailure. Altered hemostatic function, as demonstrated by elevated plasma t-P
A antigen levels, is predictive of subsequent allograft failure in cardiac
transplant recipients. In addition,the presence of anti-THP-1 cell antibodi
es in these patients is predictive of allograft failure. (C) 2001 by Excerp
ta Medico, Inc.