(Circulation. 1995;91:619-622.)
© 1995 American Heart Association, Inc.
Articles |
Differential Expression of Tissue Factor Protein in Directional Atherectomy Specimens From Patients With Stable and Unstable Coronary Syndromes
From the Division of Cardiology, Duke University and Durham VA Medical Centers, Durham, NC, and the Cardiovascular Biology Research Program (J.H.M.), Oklahoma Medical Research Foundation, Oklahoma City, Okla.
Correspondence to Brian H. Annex, MD, Duke University Medical Center, 508 Fulton St, Box 111A, Durham, NC 27705.
Background Tissue factor (TF) is a cell membrane–associated protein that catalyzes the rate-limiting step of the extrinsic coagulation pathway, which is the major source of thrombin production in vivo. To explore the potential role that TF may play in ischemic coronary syndromes, directional coronary atherectomy specimens were tested for the presence of TF protein using immunohistochemical techniques.
Methods and Results Frozen sections from atherectomy specimens in 61 patients were examined for TF expression using an IgG murine monoclonal antibody against human TF. Patients were classified according to their admission diagnosis as having either an unstable or a stable coronary syndrome. An unstable coronary syndrome was defined as either angina pectoris occurring at rest or post–myocardial infarction (<1 week) angina. Stable coronary syndromes included patients with stable, progressive, and new-onset (<6 weeks) angina without rest pain. TF was detected in 15 (43%) of 35 patients with unstable coronary syndromes versus only 3 (12%) of 26 patients with stable coronary syndromes (odds ratio, 5.7; 95% confidence interval, 1.3 to 24.3; P=.018). Within the subgroup of patients with unstable coronary syndromes, TF was detected in 14 (60%) of 25 patients with de novo lesions versus only 1 (10%) of 10 patients with a restenosis lesion (P<.02). An additional 8 patients with stable coronary syndromes due to a restenosis lesion were also negative for TF. Therefore, the overall incidence of TF expression was only 6% (1 of 18) in restenosis lesions compared with 33% (14 of 43) in de novo lesions (P<.03).
Conclusions This study provides the first description of TF protein expression in human coronary artery lesions in vivo. Tissue factor was readily detected in de novo lesions in patients with unstable coronary syndromes, suggesting a role for TF in the pathogenesis of this disease process. Conversely, TF was rarely detected in patients with restenosis lesions even if the resulting clinical presentation was an unstable coronary syndrome. These results may have implications for the management of patients with unstable angina from de novo lesions and patients with ischemic symptoms from a restenosis lesion.
Key Words: angioplasty • thrombosis • angina • stenosis
This article has been cited by other articles:
 |
|
 |
|
  N. Mackman and M. B. Taubman Does Tissue Factor Expression by Vascular Smooth Muscle Cells Provide a Link Between C-Reactive Protein and Cardiovascular Disease? Arterioscler Thromb Vasc Biol, April 1, 2008; 28(4): 601 - 603. [Full Text] [PDF]
|
|
|
|
 |
|
 G. G. Camici, J. Steffel, A. Akhmedov, N. Schafer, J. Baldinger, U. Schulz, K. Shojaati, C. M. Matter, Z. Yang, T. F. Luscher, et al. Dimethyl Sulfoxide Inhibits Tissue Factor Expression, Thrombus Formation, and Vascular Smooth Muscle Cell Activation: A Potential Treatment Strategy for Drug-Eluting Stents Circulation, October 3, 2006; 114(14): 1512 - 1521. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. E. Tilley, B. Pedersen, R. Pawlinski, Y. Sato, J. H. Erlich, Y. Shen, S. Day, Y. Huang, D. T. Eitzman, W. A. Boisvert, et al. Atherosclerosis in Mice Is Not Affected by a Reduction in Tissue Factor Expression Arterioscler Thromb Vasc Biol, March 1, 2006; 26(3): 555 - 562. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. Steffel, T. F. Luscher, and F. C. Tanner Tissue Factor in Cardiovascular Diseases: Molecular Mechanisms and Clinical Implications Circulation, February 7, 2006; 113(5): 722 - 731. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Malarstig, T. Tenno, N. Johnston, B. Lagerqvist, T. Axelsson, A.-C. Syvanen, L. Wallentin, and A. Siegbahn Genetic Variations in the Tissue Factor Gene Are Associated With Clinical Outcome in Acute Coronary Syndrome and Expression Levels in Human Monocytes Arterioscler Thromb Vasc Biol, December 1, 2005; 25(12): 2667 - 2672. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Cirillo, P. Golino, P. Calabro, G. Cali, M. Ragni, S. De Rosa, G. Cimmino, M. Pacileo, R. De Palma, L. Forte, et al. C-reactive protein induces tissue factor expression and promotes smooth muscle and endothelial cell proliferation Cardiovasc Res, October 1, 2005; 68(1): 47 - 55. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. A. Morrow, S. A. Murphy, C. H. McCabe, N. Mackman, H. C. Wong, E. M. Antman, and on behalf of the PROXIMATE-TIMI 27 Investigators Potent inhibition of thrombin with a monoclonal antibody against tissue factor (Sunol-cH36): results of the PROXIMATE-TIMI 27 trial Eur. Heart J., April 1, 2005; 26(7): 682 - 688. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Mackman Role of Tissue Factor in Hemostasis, Thrombosis, and Vascular Development Arterioscler Thromb Vasc Biol, June 1, 2004; 24(6): 1015 - 1022. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Viswambharan, X.-F. Ming, S. Zhu, A. Hubsch, P. Lerch, G. Vergeres, S. Rusconi, and Z. Yang Reconstituted High-Density Lipoprotein Inhibits Thrombin-Induced Endothelial Tissue Factor Expression Through Inhibition of RhoA and Stimulation of Phosphatidylinositol 3-Kinase but not Akt/Endothelial Nitric Oxide Synthase Circ. Res., April 16, 2004; 94(7): 918 - 925. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Golino, A. Ravera, M. Ragni, P. Cirillo, O. Piro, and M. Chiariello Involvement of Tissue Factor Pathway Inhibitor in the Coronary Circulation of Patients With Acute Coronary Syndromes Circulation, December 9, 2003; 108(23): 2864 - 2869. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Levi, T. T Keller, E. van Gorp, and H. ten Cate Infection and inflammation and the coagulation system Cardiovasc Res, October 15, 2003; 60(1): 26 - 39. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Jeanpierre, T. Le Tourneau, I. Six, C. Zawadzki;, E. Van Belle, M. D. Ezekowitz, R. Bordet, S. Susen, B. Jude, and D. Corseaux Dietary Lipid Lowering Modifies Plaque Phenotype in Rabbit Atheroma After Angioplasty: A Potential Role of Tissue Factor Circulation, October 7, 2003; 108(14): 1740 - 1745. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. J. Nusz, D. C. White, Q. Dai, A. M. Pippen, M. A. Thompson, G. B. Walton, C. J. Parsa, W. J. Koch, and B. H. Annex Vascular rarefaction in peripheral skeletal muscle after experimental heart failure Am J Physiol Heart Circ Physiol, October 1, 2003; 285(4): H1554 - H1562. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D Tousoulis, G Davies, C Stefanadis, P Toutouzas, and J A Ambrose Inflammatory and thrombotic mechanisms in coronary atherosclerosis Heart, September 1, 2003; 89(9): 993 - 997. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. D'Andrea, M. Ravera, P. Golino, A. Rosica, M. De Felice, M. Ragni, P. Cirillo, F. Vigorito, N. Corcione, P. Tommasini, et al. Induction of Tissue Factor in the Arterial Wall During Recurrent Thrombus Formation Arterioscler Thromb Vasc Biol, September 1, 2003; 23(9): 1684 - 1689. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Sambola, J. Osende, J. Hathcock, M. Degen, Y. Nemerson, V. Fuster, J. Crandall, and J. J. Badimon Role of Risk Factors in the Modulation of Tissue Factor Activity and Blood Thrombogenicity Circulation, February 25, 2003; 107(7): 973 - 977. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M.-Z. Cui, G. Zhao, A. L. Winokur, E. Laag, J. R. Bydash, M. S. Penn, G. M. Chisolm, and X. Xu Lysophosphatidic Acid Induction of Tissue Factor Expression in Aortic Smooth Muscle Cells Arterioscler Thromb Vasc Biol, February 1, 2003; 23(2): 224 - 230. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. N. Wilcox, S. Noguchi, and J. Casanova Extrahepatic Synthesis of Factor VII in Human Atherosclerotic Vessels Arterioscler Thromb Vasc Biol, January 1, 2003; 23(1): 136 - 141. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Q. Dai, M. A Thompson, A. M Pippen, H. Cherwek, D. A Taylor, and B. H Annex Alterations in endothelial cell proliferation and apoptosis contribute to vascular remodeling following hind-limb ischemia in rabbits Vascular Medicine, May 1, 2002; 7(2): 87 - 91. [Abstract] [PDF]
|
|
|
|
 |
|
 B. D. Duscha, B. H. Annex, H. J. Green, A. M. Pippen, and W. E. Kraus Deconditioning fails to explain peripheral skeletal muscle alterations in men with chronic heart failure J. Am. Coll. Cardiol., April 3, 2002; 39(7): 1170 - 1174. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. H.M Moons, M. Levi, and R. J.G Peters Tissue factor and coronary artery disease Cardiovasc Res, February 1, 2002; 53(2): 313 - 325. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Ardissino, P. A. Merlini, K. A. Bauer, E. Bramucci, M. Ferrario, R. Coppola, R. Fetiveau, S. Lucreziotti, R. D. Rosenberg, and P. M. Mannucci Thrombogenic potential of human coronary atherosclerotic plaques Blood, November 1, 2001; 98(9): 2726 - 2729. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Golino, P. Cirillo, P. Calabro', M. Ragni, D. D'Andrea, E. V. Avvedimento, F. Vigorito, N. Corcione, F. Loffredo, and M. Chiariello Expression of exogenous tissue factor pathway inhibitor in vivo suppresses thrombus formation in injured rabbit carotid arteries J. Am. Coll. Cardiol., August 1, 2001; 38(2): 569 - 576. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. Badimon, G. Vilahur, S. Sanchez, and X. Duran Atheromatous plaque formation and thrombogenesis: formation, risk factors and therapeutic approaches Eur. Heart J. Suppl., August 1, 2001; 3(suppl_I): I16 - I22. [Abstract] [PDF]
|
|
|
|
 |
|
 F. De Lorenzo, A. Noorani, and V.V. Kakkar Current trends in the management of thromboembolic events QJM, April 1, 2001; 94(4): 179 - 185. [Full Text] [PDF]
|
|
|
|
 |
|
 P. Zoldhelyi, Z.-Q. Chen, H. S. Shelat, J. M. McNatt, and J. T. Willerson Local gene transfer of tissue factor pathway inhibitor regulates intimal hyperplasia in atherosclerotic arteries PNAS, March 27, 2001; 98(7): 4078 - 4083. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Ebeling, C. Geczy, A. Nakagomi, and S. B. Freedman Monocyte Tissue Factor Induction by C-Reactive Protein and Relationship With Hormone Replacement Treatment Response Circulation, February 27, 2001; 103 (8): e49 - e49. [Full Text] [PDF]
|
|
|
|
 |
|
 U. Rauch, J. I. Osende, V. Fuster, J. J. Badimon, Z. Fayad, and J. H. Chesebro Thrombus Formation on Atherosclerotic Plaques: Pathogenesis and Clinical Consequences Ann Intern Med, February 6, 2001; 134(3): 224 - 238. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. P. Neve, D. Corseaux, G. Chinetti, C. Zawadzki, J.-C. Fruchart, P. Duriez, B. Staels, and B. Jude PPAR{{alpha}} Agonists Inhibit Tissue Factor Expression in Human Monocytes and Macrophages Circulation, January 16, 2001; 103(2): 207 - 212. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. Minnema, R. J. G. Peters, R. de Winter, Y. P. T. Lubbers, S. Barzegar, K. A. Bauer, R. D. Rosenberg, C. E. Hack, and H. t. Cate Activation of Clotting Factors XI and IX in Patients With Acute Myocardial Infarction Arterioscler Thromb Vasc Biol, November 1, 2000; 20(11): 2489 - 2493. [Abstract] [Full Text] [PDF]
|
|