Abstract | BACKGROUND AND OBJECTIVE: METHODS: Consecutive patients (n = 170) with a history of coronary stenting undergoing elective angiography were studied. Blood samples for thrombelastography, light transmittance aggregometry, and lipid levels were obtained prior to cardiac catheterization. RESULTS: Sixty-nine patients (41%) had ISR (>50% luminal diameter stenosis). Among patients with ISR, 40 (58%) had ISR in more than one stent bed. Patients with ISR were more often female (37.7% vs. 21.8%, P = 0.04), had higher thrombin-induced platelet- fibrin clot strength (TIP-FCS) (69.9 mm vs. 65.6 mm, P < 0.001), and a higher ApoB/A1 ratio (0.65 vs. 0.59, P = 0.03). In patients on dual antiplatelet therapy (n = 86), there were no differences in ADP-, arachidonic acid-, and collagen-induced platelet aggregation between groups. The frequency of patients with ISR increased with TIP-FCS quartiles and by ROC analysis, TIP-FCS = 67.0 mm was the cutpoint for identification of ISR (AUC = 0.80 (95%CI 0.73-0.87, P < 0.0001). By multivariate analysis, TIP-FCS ≥67.0 mm strongly associated with ISR (OR = 7.3, P = 0.004). CONCLUSION: Patients with ISR identified at the time of cardiac catheterization have a prothrombotic phenotype indicated by high TIP-FCS, a novel marker. Studies to confirm the prognostic utility of high TIP-FCS for the development of ISR are ongoing.
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Authors | Kevin P Bliden, Udaya S Tantry, Martin G Gesheff, Christopher J Franzese, Shachi Pandya, Peter P Toth, Denny P Mathew, Rahul Chaudhary, Paul A Gurbel |
Journal | Journal of interventional cardiology
(J Interv Cardiol)
Vol. 29
Issue 2
Pg. 168-78
(Apr 2016)
ISSN: 1540-8183 [Electronic] United States |
PMID | 26822493
(Publication Type: Journal Article)
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Copyright | © 2016, Wiley Periodicals, Inc. |
Chemical References |
- Biomarkers
- Lipids
- Fibrin
- Thrombin
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Topics |
- Aged
- Biomarkers
(blood)
- Blood Platelets
(physiology)
- Coronary Restenosis
(blood, etiology)
- Coronary Vessels
(diagnostic imaging)
- Female
- Fibrin
(analysis)
- Humans
- Lipids
(blood)
- Logistic Models
- Male
- Middle Aged
- Percutaneous Coronary Intervention
(adverse effects)
- Platelet Aggregation
(physiology)
- ROC Curve
- Stents
(adverse effects)
- Thrombelastography
(methods)
- Thrombin
(analysis)
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